Heart failure clinics
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Heart failure clinics · Apr 2008
The cholesterol paradox revisited: heart failure, systemic inflammation, and beyond.
The pathophysiologic understanding of chronic heart failure has made significant advances over the last decades. Counterintuitively, high levels of plasma cholesterol are associated with better survival, perhaps because plasma lipoproteins are able to scavenge lipopolysaccharide, a cell-wall component from gram-negative bacteria. ⋯ This article explores the cholesterol paradox in patients who have chronic heart failure and extends this view to patients who have sepsis. Also discussed is the potential of statins, which might be able to exert beneficial effects in both clinical conditions, despite lowering plasma cholesterol values.
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Heart failure clinics · Apr 2008
Investigations of statins in heart failure: inflammatory biomarkers and hormones.
The primary role of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) is to treat dyslipidemia. The clinical benefits with statin therapy have been demonstrated in the primary and secondary prevention of atherosclerotic vascular diseases. More recently, it has been observed that pleiotropic effects of statins (which may or may not be associated with lipid lowering) have been described as treatment of various cardiovascular disease processes and in noncardiac disease processes. This article evaluates the potential mechanisms for these effects in the management of heart failure and postulates their clinical and beneficial use.