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Statins prevent cardiovascular events, including deaths in patients with coronary artery disease. Intuitively, they should do the same for people with heart failure caused by the same disease. But rosuvastatin recently surprised researchers by failing to work in a large placebo controlled trialtrial.
The 5011 participants were all over 60 with moderate or severe heart failure caused by ischaemia. Adding 10 mg a day of rosuvastatin to their already complex treatment regimens did not prolong survival or protect them from heart attacks or strokes. The only benefit, compared with placebo, was a small reduction in hospital admissions for cardiovascular causes (hazard ratio 0.92, 95% CI 0.85 to 0.99), mostly heart failure. Side effects were, if anything, more common in controls.
The researchers aren't sure why the statin didn't behave as expected. Perhaps the disease was too advanced to benefit. Or perhaps patients' other drugs obscured any extra treatment effect from the statin. An editorial suggests that statins other than rosuvastatin may produce different results (doi: 10.1056/NEJMe0707221). We have been misled before by the widespread assumption that all statins are the same.