Statin use and survival in patients with chronic heart failure - results from two observational studies with 5200 patients

Stefan D. Anker, Andrew L. Clark, Ralf Winkler, Christian Zugck, Mariantonietta Cicoira, Piotr Ponikowski, Constantinos H. Davos, Waldemar Banasiak, Piero Zardini, Markus Haass, Jochen Senges, Andrew J S Coats, Philip A. Poole-Wilson, Bertram Pitt

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)234-242
Number of pages9
JournalInternational Journal of Cardiology
Issue number2
Publication statusPublished - Sep 20 2006


  • Body mass index
  • Cholesterol
  • Chronic heart failure
  • mortality
  • Statin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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