Researchers examine benefits of statins for heart failure patients

　　奥兰多，2007年11月5日，AHA2007科学年会上公布了CORONA（the Sweden-based Controlled Rosuvastatin Multinational Trial in Heart Failure）试验的最新研究进展，该研究的目的是测定患有缺血性心脏病和收缩性心衰的患者在优化治疗的基础上增加10mg罗伐他汀（rosuvastatin）治疗方案的有效性和安全性。

　　CORONA试验的研究者之一Åke Hjalmarson谈到：“因为在过去针对他汀类药物所作的安慰剂对照试验中，有症状心衰患者被排除，所以此类疾病能否从他汀类药物治疗中获益尚不确定”

　　CORONA 是一项随机、双盲、安慰剂对照研究，该研究入选了5,011例慢性有症状的收缩性心衰（由冠心病引起）患者。患者平均年龄为73岁，

　　24%为女性，37%患者为心衰II级（NYHA），62%的患者为心衰III级（NYHA）。入选患者的平均射血分数为31%（射血分数是测量每次心脏收缩有多少血液从左心室泵出的度量值，正常值为≥50%）。

　　入选患者的总胆固醇平均水平为200mg/dl。在试验之前患者都未预先服用降血脂药物。患者病史主要包括：60%的患者有心脏病发作，63%伴有高血压，30%伴有糖尿病。

　　Hjalmarson 谈到：“这些患者的心力衰竭都得到了很好的治疗”，其中87%的患者使用了髓袢利尿剂或者噻嗪类利尿剂，39%使用了醛固酮拮抗剂，91%应用了ACEI或者血管紧张素I（AT-I）阻滞剂，75%采用了β受体阻滞剂，33%采用了洋地黄。另外，51%的患者应用了阿司匹林，36%采用了抗凝药物。

　　患者被随机分组到罗伐他汀（10mg）和使用其它药物治疗的安慰剂组，平均随访时间为2.5年。

　　CORONA试验的主要目标是测定罗伐他汀是否能够降低心源性死亡、非致命性心脏病发作或非致命性卒中患者的数量。

　　（来源：http://scientificsessions.americanheart.org/）

Researchers examine benefits of statins for heart failure patients

ORLANDO, Nov. 5 – Results of a clinical trial to determine the efficacy and safety of adding rosuvastatin 10 mg to optimal therapy in patients with ischemic heart disease and systolic heart failure were presented as late-breaking research at the American Heart Association’s Scientific Sessions 2007.

“Because patients with symptomatic heart failure were excluded from past placebo-controlled trials with statins, the benefits and risks of statins in the treatment of heart failure remain uncertain,” said Åke Hjalmarson, an investigator in the Sweden-based Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA).  

CORONA was designed to clarify the role of statin therapy in treating patients with systolic heart failure.

CORONA is a randomized, double-blind, placebo-controlled study of 5,011 men and women with chronic symptomatic systolic heart failure (caused by coronary artery disease).  Average patient age was 73 years, 24 percent were women, 37 percent were in New York Heart Association (NYHA) class II heart failure and 62 percent in class III.  The average ejection fraction (EF) was 31 percent.  Ejection fraction is a measure of how much blood the heart’s left ventricle pumps out with each contraction.  The normal EF is 50 percent or greater.

The average total cholesterol among patients was 200 mg/dL.   Participants were not already taking cholesterol-lowering drugs.  Patient medical histories included 60 percent with a history of heart attack, 63 percent with hypertension and 30 percent with diabetes.

“These patients were well-treated for their heart failure,” Hjalmarson said, with 87 percent on loop or thiazide diuretics, 39 percent on aldosterone antagonists, 91 percent taking an ACE inhibitor or AT-I blocker, 75 percent taking a beta-blocker, and 33 percent taking digitalis.   In addition, 51 percent were taking aspirin and 36 percent taking anticoagulants.

Patients were randomized to receive either rosuvastatin (10 mg) or placebo along with all other medications. Average follow-up time was 2.5 years.

The primary objective of CORONA was to determine whether rosuvastatin reduces the number of patients suffering from cardiovascular death, non-fatal heart attack or non-fatal stroke.

Support for this study was provided by AstraZeneca.