Despite retro- spective analyses and small trials demonstrating ben- eficial effects of statins in patients with HF, 2 large, well-executed, prospective, randomized trials revealed that statin treatment does not confer significant clini- cal benefit in patients with HF of either ischemic or nonischemic origin. Thus, the routine use of statins to treat HF of any type is not indicated outside the cur- rent practice guidelines for the primary and secondary prevention of atherosclerotic vascular disease.8,275,276 Similarly, according to the 2013 ACC/AHA Guide- line on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, 5 statin therapy is not routinely recommended for individuals with NYHA class II to IV HF (Table 10). That said, pa- tients with ischemic cardiomyopathy who are already on statins may be continued on them. Moreover, be- cause of the established effect of statins on lowering the rate of ischemic events and improving survival in patients with ischemic heart disease, statins should strongly be considered in patients with HF presenting with acute ischemic events or with evidence of signifi- cant myocardial ischemia (Table 10). In light of the ob- served inverse relationship between cholesterol levels and mortality in patients with HF, it is unknown whether the cholesterol treatment goals recommended for the general population and patients with atherosclerotic CVD apply to patients with HF and remain to be deter- mined. The 2013 ACC/AHA guideline for the treatment of blood cholesterol makes no recommendations for the initiation or discontinuation of statins in patients with NYHA class II to IV ischemic HFrEF.5 Treatment With n-3 Polyunsaturated Fatty Acids in Patients With HF The use of a different type of lipid therapy, n-3 polyun- saturated fatty acids (PUFAs), has also been investigat- ed in the treatment of HF. 