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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Effect of Statins on Mortality in Heart Failure With Preserved Ejection Fraction Without Coronary Artery Disease -
Kyohei Marume1, Seiji Takashio1, Toshiyuki Nagai2,3
1Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University.
Insights
Statins may improve survival for patients with heart failure with preserved ejection fraction (HFpEF) but without coronary artery disease (CAD). This study found statin use was associated with lower mortality in this specific patient group.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Heart failure with preserved ejection fraction (HFpEF) is a growing concern.
- The role of statins in HFpEF patients without coronary artery disease (CAD) is not well-defined.
- Understanding medication effects in specific HFpEF subgroups is crucial for treatment optimization.
Purpose of the Study:
- To investigate the association between statin use and survival in patients with HFpEF but without CAD.
- To analyze the impact of statins on mortality and rehospitalization rates in this population.
- To provide evidence for potential therapeutic strategies in HFpEF management.
Main Methods:
- Analysis of data from the JASPER registry, a prospective cohort of Japanese patients hospitalized with acute heart failure and preserved ejection fraction (LVEF ≥50%).
- Selection of 414 patients without coronary artery disease (CAD).
- Comparison of outcomes between patients prescribed statins at admission (n=81) and those not prescribed statins (n=333), using propensity score matching.
Main Results:
- In the propensity score-matched cohort, 3-year mortality was significantly lower in the statin group (HR: 0.21).
- Statin use was associated with a significantly lower incidence of non-cardiac death and rehospitalization for heart failure.
- No significant difference in cardiac death was observed between the groups; statin's benefit was independent of cholesterol levels or HF severity.
Conclusions:
- Statin therapy demonstrates a beneficial effect on mortality in patients with HFpEF and no history of CAD.
- These findings suggest statins could be a valuable treatment option for this patient subgroup.
- Further validation through large-scale, randomized clinical trials is recommended to confirm these results.
Background:
Statins might be associated with improved survival in patients with heart failure with preserved ejection fraction (HFpEF). The effect of statins in HFpEF without coronary artery disease (CAD), however, remains unclear.
Methods And Results:
From the JASPER registry, a multicenter, observational, prospective cohort with Japanese patients aged ≥20 years requiring hospitalization with acute HF and LVEF ≥50%, 414 patients without CAD were selected for outcome analysis. Based on prescription of statins at admission, we divided patients into the statin group (n=81) or no statin group (n=333). We followed them for 25 months. The association between statin use and primary (all-cause mortality) and secondary (non-cardiac death, cardiac death, or rehospitalization for HF) endpoints was assessed in the entire cohort and in a propensity score-matched cohort. In the propensity score-matched cohort, 3-year mortality was lower in the statin group (HR, 0.21; 95% CI: 0.06-0.72; P=0.014). The statin group had a significantly lower incidence of non-cardiac death (P=0.028) and rehospitalization for HF (P<0.001), but not cardiac death (P=0.593). The beneficial effect of statins on mortality did not have any significant interaction with cholesterol level or HF severity.
Conclusions:
Statin use has a beneficial effect on mortality in HFpEF without CAD. The present findings should be tested in an adequately powered randomized clinical trial.
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