Lipitor may cut hospitalizations for heart failure

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - For people with coronary artery disease, treatment with high doses of Lipitor (generic name, atorvastatin) may reduce their odds of having to be hospitalized for heart failure, according to a new report. However, this benefit is largely confined to individuals with a history of heart failure.

The findings come from an analysis of data from the Treating to New Targets (TNT) study, which has already shown that patients treated with high-dose atorvastatin had 22 percent fewer 'cardiac events' than those given low-dose atorvastatin. "The focus of our analysis was to determine if high-dose atorvastatin had any effect on hospitalizations for heart failure," Dr. David D. Waters, from San Francisco General Hospital, explained to Reuters Health.

As Waters and his colleagues note in their report in the American Heart Association's journal Circulation, statin drugs like Lipitor have effects that suggest they might be useful for treating heart failure, but there's also a possibility that they may actually worsen the condition.

The team's analysis involved 10,000 patients with heart disease who were assigned to take Lipitor at a dose of 80 milligrams or 10 milligrams per day and were followed for an average of nearly 5 years. None of them had advanced heart failure, but about 8 percent of them had a history of heart failure.

The hospitalization rate for heart failure in the high-dose group was 2.4 percent compared with 3.3 percent in the low-dose group, which translates to a reduction in risk of 26 percent.

Most of the benefit was seen in the patients with a history of heart failure. In this group, high-dose and low-dose atorvastatin were associated with hospitalization rates of 10.6 percent and 17.3 percent, respectively.

"Atorvastatin and other statins are not specifically approved to treat heart failure, but our findings suggest that if you have a patient who is taking atorvastatin for another reason -- such as high cholesterol or heart disease -- it might be smart to use the higher dose," Waters commented.

SOURCE: Circulation, February 6, 2007.