TY - JOUR
T1 - Prognostic impact of statin intensity in heart failure patients with ischemic heart disease
T2 - A report from the CHART-2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2) study
AU - for the CHART-2 Investigators
AU - Oikawa, Takuya
AU - Sakata, Yasuhiko
AU - Nochioka, Kotaro
AU - Miura, Masanobu
AU - Tsuji, Kanako
AU - Onose, Takeo
AU - Abe, Ruri
AU - Kasahara, Shintaro
AU - Sato, Masayuki
AU - Shiroto, Takashi
AU - Takahashi, Jun
AU - Miyata, Satoshi
AU - Shimokawa, Hiroaki
AU - Fukuchi, Mitsumasa
AU - Kato, Hiroshi
AU - Ogata, Masahiko
AU - Sato, Shoichi
AU - Oyama, Shigeto
AU - Demachi, Jun
AU - Nozaki, Eiji
AU - Nakamura, Akihiro
AU - Takahashi, Tohru
AU - Endo, Hideaki
AU - Kondo, Masateru
AU - Noda, Kazuki
AU - Kanazawa, Masanori
AU - Sato, Kenjiro
AU - Nakagawa, Makoto
AU - Nozaki, Tetsuji
AU - Yagi, Takuya
AU - Takahashi, Toshiaki
AU - Matsumoto, Yasuharu
AU - Ito, Kenta
AU - Nakayama, Masaharu
AU - Fukuda, Koji
AU - Sugimura, Koichiro
AU - Sato, Kimio
AU - Nakano, Makoto
AU - Yamamoto, Hiroaki
AU - Aoki, Tatsuo
AU - Hao, Kiyotaka
AU - Tatebe, Shunsuke
AU - Yamamoto, Saori
AU - Kikuchi, Yoku
AU - Suzuki, Hideaki
AU - Godo, Shigeo
AU - Nishimiya, Kensuke
AU - Yaoita, Nobuhiro
AU - Aizawa, Kentaro
AU - Saga, Chiharu
N1 - Funding Information:
This study was supported in part by the grants in aid from the Ministry of Health, Labor, and Welfare; the Ministry of Education, Culture, Sports, Science, and Technology; and the Agency for Medical Research and Development (No. 15ek0210043h0001), Tokyo, Japan.
Funding Information:
The Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, is supported in part by unrestricted research grants from Daiichi Sankyo Co., Ltd. (Tokyo, Japan), Bayer Yakuhin, Ltd. (Osaka, Japan), Kyowa Hakko Kirin Co., Ltd. (Tokyo, Japan), Kowa Pharmaceutical Co., Ltd. (Tokyo, Japan), Novartis Pharma K.K. (Tokyo, Japan), Dainippon Sumitomo Pharma, Co., Ltd. (Osaka, Japan), Nippon Boehringer Ingelheim Co., Ltd. (Tokyo, Japan), Astellas Pharma (Tokyo, Japan), AstraZeneca (Osaka, Japan), Chugai Pharmaceutical (Tokyo, Japan), GlaxoSmithKline (Tokyo, Japan), Mitsubishi Tanabe Pharma (Osaka, Japan), Mochida Pharmaceutical (Tokyo, Japan), MSD (Tokyo, Japan), Otsuka Pharmaceutical (Tokyo, Japan), Shionogi (Osaka, Japan), and Takeda Pharmaceutical (Tokyo, Japan). Shimokawa has received lecture fees from Bayer Yakuhin, Ltd. (Osaka, Japan), Daiichi Sankyo Co., Ltd. (Tokyo, Japan) and Novartis Pharma K.K. (Tokyo, Japan).
Publisher Copyright:
© 2018 The Authors.
PY - 2018/3/20
Y1 - 2018/3/20
N2 - Background--The beneficial prognostic impact of statins has been established in patients with ischemic heart disease but not in those with heart failure (HF). In addition, it is still unclear whether patients benefit from statins regardless of low-density lipoprotein cholesterol levels. Methods and Results--We examined 2444 consecutive stage C or D HF patients with ischemic heart disease registered in CHART- 2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2), a multicenter, prospective, observational cohort study in Japan. Patients were divided into 3 groups according to the Japanese standard doses of statins and statin-intensity categories defined by the 2013 American College of Cardiology and American Heart Association guidelines: higher (moderate-high)-intensity (n=868), lower (low)-intensity (n=526), and no statin (n=1050). The median follow-up period was 6.4 years (13929 person-years). Analysis with the inverse probability of treatment weighted using a propensity score for multiple treatment revealed that both the higher-intesity group (hazard ratio [HR]: 0.68; P < 0.001) and the lower-intensity group (HR: 0.82; P < 0.001) had significantly lower incidence of the primary end point-a composite of all-cause death and HF admission-compared with the no statin group. The higher-intensity statin group had significantly lower incidence of the primary end point (HR: 0.82; P < 0.001), all-cause death (HR: 0.83; P < 0.001), and HF admission (HR: 0.78; P < 0.001) than the lower-intensity statin group. Moreover, the use of statins, either higher- or lower-intensity, was associated with reduced incidence of the primary end point, regardless of low-density lipoprotein cholesterol levels. Conclusions--These results suggest that statin use, particularly the use of higher-intensity statins, has a beneficial prognostic impact in HF patients with ischemic heart disease, regardless of low-density lipoprotein cholesterol levels.
AB - Background--The beneficial prognostic impact of statins has been established in patients with ischemic heart disease but not in those with heart failure (HF). In addition, it is still unclear whether patients benefit from statins regardless of low-density lipoprotein cholesterol levels. Methods and Results--We examined 2444 consecutive stage C or D HF patients with ischemic heart disease registered in CHART- 2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2), a multicenter, prospective, observational cohort study in Japan. Patients were divided into 3 groups according to the Japanese standard doses of statins and statin-intensity categories defined by the 2013 American College of Cardiology and American Heart Association guidelines: higher (moderate-high)-intensity (n=868), lower (low)-intensity (n=526), and no statin (n=1050). The median follow-up period was 6.4 years (13929 person-years). Analysis with the inverse probability of treatment weighted using a propensity score for multiple treatment revealed that both the higher-intesity group (hazard ratio [HR]: 0.68; P < 0.001) and the lower-intensity group (HR: 0.82; P < 0.001) had significantly lower incidence of the primary end point-a composite of all-cause death and HF admission-compared with the no statin group. The higher-intensity statin group had significantly lower incidence of the primary end point (HR: 0.82; P < 0.001), all-cause death (HR: 0.83; P < 0.001), and HF admission (HR: 0.78; P < 0.001) than the lower-intensity statin group. Moreover, the use of statins, either higher- or lower-intensity, was associated with reduced incidence of the primary end point, regardless of low-density lipoprotein cholesterol levels. Conclusions--These results suggest that statin use, particularly the use of higher-intensity statins, has a beneficial prognostic impact in HF patients with ischemic heart disease, regardless of low-density lipoprotein cholesterol levels.
KW - Heart failure
KW - Ischemic heart disease
KW - Statin therapy
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U2 - 10.1161/JAHA.117.007524
DO - 10.1161/JAHA.117.007524
M3 - Article
C2 - 29540427
AN - SCOPUS:85043708246
VL - 7
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 6
M1 - e007524
ER -