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European Heart Journal Advance Access originally published online on July 13, 2005
European Heart Journal 2005 26(18):1931; doi:10.1093/eurheartj/ehi422
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Cholesterol levels and cholesterol lowering in idiopathic dilated cardiomyopathy

Laurent Fauchier

Service de Cardiologie B.
Centre Hospitalier Universitaire Trousseau
37044 Tours
France
Tel: +33 2 47 47 46 50
Fax: +33 2 47 47 59 19
E-mail address: lfau{at}med.univ-tours.fr

Axel de Labriolle

Service de Cardiologie A.
Centre Hospitalier Universitaire Trousseau
37044 Tours
France

We read with great interest the recent article of Dr Christ et al.1 about the prognostic significance of serum cholesterol levels in patients with idiopathic dilated cardiomyopathy (IDC). It was found that decreased cholesterol levels do not independently predict adverse prognosis in patients with IDC and that low cholesterol levels are dependent on the severity of the disease (i.e. higher NYHA class, higher left ventricular end-diastolic diameter, and lower left ventricular ejection fraction). In contrast, the authors present an intriguing curve showing that, retrospectively, the prognosis (survival or transplant free survival) was significantly better for the few patients (~15%) who received statins at any time during follow-up. As stated in the discussion, beneficial effects of statins in heart failure patients indeed appear promising in some preliminary results, even in patients without coronary artery disease.2 However, the particular analysis and results of Dr Christ may, in our opinion, be related to the fact that the patients who received statins were likely to be those with the highest cholesterol levels, i.e. those with the lower severity of the disease as suggested by the authors themselves. Therefore, it is really not sure that the better prognosis was related to the treatment with statins or to the lipid lowering. Prospective randomized intervention trials are thus particularly needed in the field.

References

  1. Christ M, Klima T, Grimm W, Mueller HH, Maisch B. Prognostic significance of serum cholesterol levels in patients with idiopathic dilated cardiomyopathy. Eur Heart J 2005. Published online ahead of print April 8, 2005.
  2. Krum H, McMurray JJ. Statins and chronic heart failure: do we need a large-scale outcome trial? J Am Coll Cardiol 2002;39:1567–1573.[Abstract/Free Full Text]

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This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
26/18/1931    most recent
ehi422v1
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Right arrow Articles by Fauchier, L.
Right arrow Articles by de Labriolle, A.
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Right arrow Articles by de Labriolle, A.
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