58S Statins and Heart

inhibition of cell migration and proliferation, and a reduction in inflammation and oxidative stress.3,4 Statins decrease events related to cardiovascular disease (CVD) in the setting of both primary and secondary prevention.5,6 Most of the large statin trials demonstrated a positive effect of statins in CHF patients. In the Scandinavian Simvastatin Survival Study (4S), new-onset CHF was lower in 228 patients (10.3%) allo-cated simvastatin compared with 184 (8.3%) receiving placebo (P <.015.).7 Moreover in 4S, the mortality rate in patients developing CHF was 25.5 % in the simvastatin group compared with 31.9 % in the placebo group, a 19 % reduction (P <.05). Among those who developed CHF, simvastatin conferred a significant reduction in mortality com-pared with placebo (relative risk, 0.63; P <.014). The 4S patients who developed CHF were more likely to have sustained a recurrent MI and have a history of diabetes mellitus, peripheral arterial dis-ease, or hypertension than patients who did not develop CHF.7 One large study monitored 24598 patients diag-nosed with CHF and no prior statin use for a median 2.4 years.8 Statin use was associated with a signifi-cantly reduced risk of death (adjusted hazard ratio [HR], 0.76; 95 % confidence interval [CI], 0.72-0.80) and risk of hospitalization for CHF (adjuste