Impact of statin use on clinical outcomes in patients with heart failure

  • Bielecka-Dabrowa A & al.
  • Lipids Health Dis
  • 31 Oct 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Statin treatment was associated with reduction in all-cause mortality, cardiovascular (CV) mortality and CV hospitalisation in heart failure (HF) with either left ventricular ejection fraction (LVEF) ≥40% or LVEF
  • Lipophilic statins might be more favourable than hydrophilic statins for patients with HF.

Why this matters

  • The role of statins in patients with HF and different LVEF levels remains unclear, particularly because of the lack of data from randomised trials in non-ischaemic HF and taking into account potential prosarcopenic effects of statins.

Study design

  • Meta-analysis of 17 studies (n=88,100) compared the effects of statin (n=42,400) vs non-statin therapy (n=45,700) on clinical outcomes in patients with HF.
  • Primary outcomes: all-cause mortality and CV mortality and hospitalisation.
  • Funding: None.

Key results

  • Statin vs non-statin users were significantly at lower risk for:
    • all-cause mortality (HR, 0.77; 95% CI, 0.72-0.83; P<.0001 i>2=63%) and
    • CV mortality (HR, 0.82; 95% CI, 0.76-0.88; P<.00001 i>2=63%) and hospitalisation (HR, 0.78; 95% CI, 0.69-0.89; P=.0003).
  • Compared with non-statin users, statin users with both EF 2=71% and HR, 0.75; 95% Cl, 0.69-0.82; P<.00001 for both>
  • Similarly, the risk for CV mortality (HR, 0.83; 95% CI, 0.77-0.90; I2=55%; P<.00001 and hr ci p=".0003," respectively hospitalisations i>2=63%, respectively) reduced in both EF groups.
  • Lipophilic vs hydrophilic statins significantly decreased:
    • CV mortality (HR 0.79; 95% Cl, 0.74–0.88 vs HR 0.94; 95% Cl, 0.85–1.05),
    • CV hospitalizations (HR 0.60; 95% Cl, 0.45–0.86 vs HR 0.78; 95% Cl, 0.50–1.22).

Limitations

  • Heterogeneity among studies.
  • Limited data available on compliance with statin therapy or statin dosage.

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