TY - JOUR
T1 - Statin use and survival in patients with chronic heart failure - results from two observational studies with 5200 patients
AU - Anker, Stefan D.
AU - Clark, Andrew L.
AU - Winkler, Ralf
AU - Zugck, Christian
AU - Cicoira, Mariantonietta
AU - Ponikowski, Piotr
AU - Davos, Constantinos H.
AU - Banasiak, Waldemar
AU - Zardini, Piero
AU - Haass, Markus
AU - Senges, Jochen
AU - Coats, Andrew J S
AU - Poole-Wilson, Philip A.
AU - Pitt, Bertram
PY - 2006/9/20
Y1 - 2006/9/20
N2 - Background: There is minimal evidence that HMG-CoA reductase inhibitors (statins) are beneficial in patients with chronic heart failure (CHF). Treatment with statins may lead to a lower mortality in CHF, independent of cholesterol levels, CHF etiology and clinical status. Methods: In a first study, we included 3132 patients with CHF from the ELITE 2 study in whom information on body mass index (BMI) and statin use at baseline were available. In a second study, we pooled the databases of 5 tertiary referral centers with 2068 CHF patients. In this cohort 705 patients were on a statin (34%), 585 of 1202 (49%) patients with ischemic etiology, and 120 of 866 (14%) patients with non-ischemic etiology (established by coronary angiography). Findings: Patients in ELITE 2 who received statin therapy at baseline (n = 397, 13%) had lower mortality (hazard ratio [HR] 0.61, 95% CI 0.45-0.83; p = 0.0007). In univariate analysis, increasing age, NYHA class, creatinine, and decreasing BMI, LVEF, and cholesterol, as well as lack of beta-blocker treatment and ischemic etiology (all p <0.002) related to higher mortality. In multivariable analysis, statin therapy related to lower mortality independently of all these variables (adjusted HR 0.66, 95% CI 0.47-0.93; p = 0.017). In the second study CHF patients on statins had lower mortality (adjusted HR 0.58, 95% CI 0.44-0.77; p = 0.0001). Both in patients with ischemic (p <0.0001) and non-ischemic etiology (p = 0.028) statin treatment related to better survival. Interpretation: In chronic heart failure, treatment with statins is related to lower mortality, independent of cholesterol levels, disease etiology and clinical status.
AB - Background: There is minimal evidence that HMG-CoA reductase inhibitors (statins) are beneficial in patients with chronic heart failure (CHF). Treatment with statins may lead to a lower mortality in CHF, independent of cholesterol levels, CHF etiology and clinical status. Methods: In a first study, we included 3132 patients with CHF from the ELITE 2 study in whom information on body mass index (BMI) and statin use at baseline were available. In a second study, we pooled the databases of 5 tertiary referral centers with 2068 CHF patients. In this cohort 705 patients were on a statin (34%), 585 of 1202 (49%) patients with ischemic etiology, and 120 of 866 (14%) patients with non-ischemic etiology (established by coronary angiography). Findings: Patients in ELITE 2 who received statin therapy at baseline (n = 397, 13%) had lower mortality (hazard ratio [HR] 0.61, 95% CI 0.45-0.83; p = 0.0007). In univariate analysis, increasing age, NYHA class, creatinine, and decreasing BMI, LVEF, and cholesterol, as well as lack of beta-blocker treatment and ischemic etiology (all p <0.002) related to higher mortality. In multivariable analysis, statin therapy related to lower mortality independently of all these variables (adjusted HR 0.66, 95% CI 0.47-0.93; p = 0.017). In the second study CHF patients on statins had lower mortality (adjusted HR 0.58, 95% CI 0.44-0.77; p = 0.0001). Both in patients with ischemic (p <0.0001) and non-ischemic etiology (p = 0.028) statin treatment related to better survival. Interpretation: In chronic heart failure, treatment with statins is related to lower mortality, independent of cholesterol levels, disease etiology and clinical status.
KW - Body mass index
KW - Cholesterol
KW - Chronic heart failure
KW - mortality
KW - Statin
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U2 - 10.1016/j.ijcard.2006.03.057
DO - 10.1016/j.ijcard.2006.03.057
M3 - Article
C2 - 16846656
AN - SCOPUS:33748628244
VL - 112
SP - 234
EP - 242
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 2
ER -