No current treatment guidelines explicitly recommend statin therapy
for patients with systolic heart failure because no single
large-scale randomized trial of heart failure patients has demonstrated
a statistically significant reduction in cardiovascular disease
(CVD) incidence or mortality with statin use.1–3 According
to the most recent 2013 American College of Cardiology
(ACC)/American Heart Association (AHA) Guideline on the Treatment
of Blood Cholesterol, ‘statin therapy is not routinely recommended
for individuals with NYHA (New York Heart Association)
class II–IV heart failure’ because ‘available evidence suggests that
initiation of statin therapy might not achieve a significant reduction
of CVD risk in patients with higher classes of NYHA heart
failure’. This is perhaps surprising given the efficacy of statins in
reducing CVD event rates significantly and substantially in most
patient groups studied.