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Statin therapy is associated with improved survival in ischemic and non-ischemic heart failure

Tamara B Horwich1, W Robb MacLellan, Gregg C Fonarow

  • 1Ahmanson-UCLA Cardiomyopathy Center, Los Angeles, California 90095-1679, USA.

Journal of the American College of Cardiology
|February 21, 2004
PubMed

Insights

Hydroxymethylglutaryl coenzyme A reductase inhibitor (statin) therapy improved survival in advanced heart failure (HF) patients. This suggests a potential therapeutic benefit for statins in HF, warranting further investigation.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Statins are known to reduce mortality in coronary artery disease (CAD).
  • The impact of statin therapy in heart failure (HF) patients is less understood.
  • Potential risks and benefits of statins in HF have been described.

Purpose of the Study:

  • To investigate the impact of hydroxymethylglutaryl coenzyme A reductase inhibitor (statin) therapy in patients with advanced heart failure (HF).

Main Methods:

  • A cohort of 551 patients with systolic HF (left ventricular ejection fraction [EF] ≤40%) was studied.
  • Survival without the necessity of urgent heart transplantation was determined.
  • Patients were referred to a single university center for clinical management and/or transplant evaluation.

Main Results:

  • Statin use was associated with improved survival without urgent transplantation in both non-ischemic and ischemic HF patients (91% vs. 72% and 81% vs. 63% at one-year, respectively).
  • After risk adjustment, statin therapy remained an independent predictor of improved survival (hazard ratio 0.41).
  • Patients receiving statins were older, more likely male, with higher rates of hypertension, diabetes, and smoking.

Conclusions:

  • Statin therapy is associated with improved survival in patients with both ischemic and non-ischemic HF.
  • Randomized trials are needed to confirm a therapeutic benefit of statins in HF patients.
Abstract

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