Prognostic impact of statin use in patients with heart failure and preserved ejection fraction: A report from the chart-2 study

Kotaro Nochioka, Yasuhiko Sakata, Satoshi Miyata, Masanobu Miura, Tsuyoshi Takada, Soichiro Tadaki, Ryoichi Ushigome, Takeshi Yamauchi, Jun Takahashi, Hiroaki Shimokawa

Research output: Contribution to journalArticlepeer-review

43 Citations (Scopus)

Abstract

Background: The effectiveness of statins remains to be examined in patients with heart failure (HF) with preserved ejection fraction (EF). Methods and Results: Among 4,544 consecutive HF patients registered in the Chronic Heart Failure Registry and Analysis in the Tohoku district-2 (CHART-2) between 2006 and 2010, 3,124 had EF ≥50% (HFpEF; mean age 69 years; male 65%) and 1,420 had EF <50% (HF with reduced EF (HFrEF); mean age 67 years; male 75%). The median follow-up was 3.4 years. The 3-year mortality in HFpEF patients was lower in patients receiving statins [8.7% vs. 14.5%, adjusted hazard ratio (HR) 0.74; 95% confidence interval (CI), 0.58–0.94; P<0.001], which was confirmed in the propensity score-matched cohort (HR, 0.72; 95% CI, 0.49–0.99; P=0.044). The inverse probability of treatment weighted further confirmed that statin use was associated with reduced incidence of all-cause death (HR, 0.71; 95% CI, 0.62–0.82, P<0.001) and noncardiovascular death (HR, 0.53; 95% CI, 0.43–0.66, P<0.001), specifically reduction of sudden death (HR, 0.59; 95% CI, 0.36–0.98, P=0.041) and infection death (HR, 0.53; 95% CI, 0.35–0.77, P=0.001) in HFpEF. In the HFrEF cohort, statin use was not associated with mortality (HR, 0.87; 95% CI, 0.73–1.04, P=0.12), suggesting a lack of statin benefit in HFrEF patients. Conclusions: These results suggest that statin use is associated with improved mortality rates in HFpEF patients, mainly attributable to reductions in sudden death and noncardiovascular death.

Original languageEnglish
Pages (from-to)574-582
Number of pages9
JournalCirculation Journal
Volume79
Issue number3
DOIs
Publication statusPublished - 2015

Keywords

  • Heart failure
  • Lipids
  • Noncardiovascular death
  • Statins
  • Sudden death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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