- 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.
- 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).
- 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.
- No cholesterol measurements done.