Heart failure: statins do not improve survival after 1 year

  • Al-Gobari M & al.
  • Am J Cardiovasc Drugs
  • 10 Apr 2019

  • International Clinical Digest
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Takeaway

  • In patients with heart failure (HF) not stratified by ejection fraction, statin prescription was not associated with survival benefit after 1 year in the EPICAL2 trial .

Why this matters

  • Patients with HF were largely excluded from most statin trials, and results of observational studies have been mixed.

Key results

  • Mortality: 21% in treated group vs 31% in control.
  • Adjusted analyses showed no significant difference (P=.317).
  • All-cause mortality did not improve with statin treatment (P=.083 and .34 for 2 analytic approaches).
  • Cox proportional hazards model showed no decreased risk with statins either: HR, 0.85 (95% CI, 0.66-1.11).
  • Statin effects did not vary with ejection fraction.
  • Unusual finding: for patients with unknown/missing ejection fraction information, statins were associated with significant mortality risk reduction: OR, 0.48 (95% CI, 0.25-0.90).

Study design

  • Data from Epidémiologie et Pronostic de l'Insuffisance Cardiaque Aiguë en Lorraine (EPICAL2) cohort study; 2032 HF patients in 21 French hospitals, October 2011-2012. 
  • Funding: National Hospital Program of Clinical Research, French Ministry of Health. 

Limitations

  • No cholesterol measurements done.

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