Lamia Mohamed El Wakeel, Hazem Khorshid, Ebtissam Abdel Ghaffar Darweesh, Marwa Adel Ahmed
Aims: There are insufficient direct comparative studies addressing the impact of the
type of statin on their respective efficacy in heart failure (HF). The aim of the current
study was to compare the effects of lipophilic (atorvastatin) vs hydrophilic
(rosuvastatin) on left ventricular function, inflammatory and fibrosis biomarkers in
patients with chronic HF.
Methods: This was a prospective, randomized, comparative, parallel study. A total of
85 patients with chronic HF optimized on guideline directed therapy were randomized to receive either atorvastatin 40 mg (n = 42) or rosuvastatin 20 mg (n = 43) for
6 months. Baseline and follow-up assessment included 2D echocardiography, measurement of N-terminal pro-brain natriuretic peptide, interleukin-6 and soluble suppression of tumorigenicity 2 (sST2) levels, liver enzymes and lipid profile.
Results: The increase in left ventricular ejection fraction was significantly higher in
the atorvastatin group compared to the rosuvastatin group (6.5% [3–11] vs 4% [2–5],
P = .006). The reduction in left ventricular end diastolic and end systolic volume was
comparable between the 2 groups. The decrease in sST2 levels in pg/mL was significantly higher in the atorvastatin compared to the rosuvastatin group (−255 [−383 to
−109.8 vs − 151 [−216 to −69], P = .003). There was a significant reduction in Nterminal pro-brain natriuretic peptide and interleukin-6 levels in both groups, yet the
reduction was comparable in both groups.
Conclusion: The study results suggest that lipophilic atorvastatin is superior to hydrophilic rosuvastatin in increasing left ventricular ejection fraction and reducing fibrosis
marker sST2 in HF patients.
Trial registration ID: NCT03255044, registered on 21 August 2017.
heart failure, hydrophilic, lipophilic, remodelling, soluble ST2, statin