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Association Between Use of Statins and Mortality in Patients With Heart Failure and Ejection Fraction of greater than= 50%
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
Karolinska Institute, Sweden.
Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0001-6353-8041
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2015 (English)In: Circulation Heart Failure, ISSN 1941-3289, E-ISSN 1941-3297, Vol. 8, no 5, 862-870 p.Article in journal (Refereed) Published
Abstract [en]

Background The pathophysiology of heart failure with preserved ejection fraction is poorly understood, but may involve a systemic proinflammatory state. Therefore, statins might improve outcomes in patients with heart failure with preserved ejection fraction defined as 50%. Methods and Results Of 46 959 unique patients in the prospective Swedish Heart Failure Registry, 9140 patients had heart failure and ejection fraction 50% (age 7711 years, 54.0% women), and of these, 3427 (37.5%) were treated with statins. Propensity scores for statin treatment were derived from 40 baseline variables. The association between statin use and primary (all-cause mortality) and secondary (separately, cardiovascular mortality, and combined all-cause mortality or cardiovascular hospitalization) end points was assessed with Cox regressions in a population matched 1:1 based on age and propensity score. In the matched population, 1-year survival was 85.1% for statin-treated versus 80.9% for untreated patients (hazard ratio, 0.80; 95% confidence interval, 0.72-0.89; Pless than0.001). Statins were also associated with reduced cardiovascular death (hazard ratio, 0.86; 95% confidence interval, 0.75-0.98; P=0.026) and composite all-cause mortality or cardiovascular hospitalization (hazard ratio, 0.89; 95% confidence interval, 0.82-0.96; P=0.003). Conclusions In heart failure with ejection fraction 50%, the use of statins was associated with improved outcomes. The mechanisms should be evaluated and the effects tested in a randomized trial.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS and WILKINS , 2015. Vol. 8, no 5, 862-870 p.
Keyword [en]
heart failure; heart failure with preserved ejection fraction; mortality; propensity score; statin intervention
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Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-121899DOI: 10.1161/CIRCHEARTFAILURE.115.002143ISI: 000361186000005PubMedID: 26243795OAI: oai:DiVA.org:liu-121899DiVA: diva2:860757
Note

Funding Agencies|County Council of Ostergotland; Swedish Heart and Lung Foundation; University of Linkoping; County Council of Stockholm; Swedish Research Council; Swedish Heart Failure Research Foundation

Available from: 2015-10-13 Created: 2015-10-12 Last updated: 2016-04-24

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Alehagen, UrbanDahlström, Ulf
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in Linköping
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Circulation Heart Failure
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