Association Between Use of Statins and Mortality in Patients With Heart Failure and Ejection Fraction of greater than= 50%
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
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.
heart failure; heart failure with preserved ejection fraction; mortality; propensity score; statin intervention
IdentifiersURN: urn:nbn:se:liu:diva-121899DOI: 10.1161/CIRCHEARTFAILURE.115.002143ISI: 000361186000005PubMedID: 26243795OAI: oai:DiVA.org:liu-121899DiVA: diva2:860757
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 Foundation2015-10-132015-10-122016-04-24