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Rosuvastatin in older patients with systolic heart failure
John Kjekshus1, Eduard Apetrei, Vivencio Barrios
1Department of Cardiology, University of Oslo, Rikshospitalet University Hospital, Oslo, Norway. john.kjekshus@medisin.uio.no
The New England Journal of Medicine
|November 7, 2007
Summary
Rosuvastatin did not significantly lower the risk of major cardiovascular events or death in patients with systolic heart failure. However, it did reduce cardiovascular hospitalizations without increasing adverse events.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Systolic heart failure patients are often excluded from statin trials due to theoretical risks.
- Acute coronary events are less common in this population.
Purpose of the Study:
- To evaluate the efficacy and safety of rosuvastatin in older patients with systolic heart failure.
- To assess the impact of rosuvastatin on major adverse cardiovascular events and hospitalizations.
Main Methods:
- 5011 patients aged 60+ with NYHA class II-IV systolic heart failure were randomized.
- Participants received either 10 mg of rosuvastatin daily or a placebo.
- The primary outcome was a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke.
Main Results:
- Rosuvastatin significantly reduced LDL cholesterol and high-sensitivity C-reactive protein levels.
- No significant difference was observed in the primary composite outcome (HR 0.92, P=0.12) or all-cause mortality (HR 0.95, P=0.31).
- A significant reduction in cardiovascular hospitalizations was noted in the rosuvastatin group (P<0.001) with no increased safety concerns.
Conclusions:
- Rosuvastatin did not meet the primary efficacy endpoint in older adults with systolic heart failure.
- The drug demonstrated a significant benefit in reducing cardiovascular hospitalizations.
- Rosuvastatin was safe and well-tolerated in this patient population.
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