Mortality and morbidity of newly diagnosed heart failure treated with statins: a propensity-adjusted cohort study.
BACKGROUND
The effect of treatment with statins on the prognosis of newly diagnosed heart failure (ndHF) is not established. We evaluate the relationship of commencing treatment with statins (CTS) with the mortality and the morbidity of ndHF, systolic (HF-DSF) and non-systolic (HF-PSF).


METHODS
Prospective propensity-adjusted cohort study over 5 years on 2573 patients with ndHF. The main outcomes were all-cause and cardiovascular mortality, hospitalizations and visits. We analyze the independent relationship of CTS with the mortality and the morbidity, stratifying patients for cardiovascular co-morbidity, after adjusting for potential confounders.


RESULTS
1343 patients (52.2%) CTS, 1071 (39.5%) died, and 1729 (67.2%) were hospitalized. CTS was associated not only with a lower mortality: RR for HF-overall (CI 95%) 0.23 (0.10 to 0.36), RR for HF-PSF 0.34 (0.21 to 0.47), and RR for HF-DSF 0.20 (0.09 to 0.31), but with dose-dependency (statin>20 mg/day vs. statin<=20 mg/day): RR for HF-overall 0.49 (0.33 to 0.67), RR for HF-PSF 0.53 (0.39 to 0.70), and RR for HF-DSF 0.37 (0.26 to 0.52), and with a lower rate of hospitalization (per 100 persons-year): HF-overall (13.3 vs. 18.2), HF-PSF (13.9 vs. 19.7), and HF-DSF (12.7 vs. 16.6), (P<0.001 in all cases), even after adjustment for the propensity to take statins, or other medications, and other potential confounders.


CONCLUSIONS
The commencement of treatment with statins is associated with a dose-dependent reduction of the mortality and of the morbidity of patients with ndHF (systolic or non-systolic).
Gomez-Soto
Francisco M
FM
Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain. francisco.gomez@uca.es
Romero
Sotero P
SP
Bernal
Jose A
JA
Escobar
Miguel A
MA
Puerto
Jose L
JL
Andrey
Jose L
JL
Ruiz
Pedro
P
Gomez
Francisco
F
D000368:Aged; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D054144:Heart Failure, Diastolic / Q000188:drug therapy / Q000401:mortality; D054143:Heart Failure, Systolic / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D017379:Hypertrophy, Left Ventricular / Q000188:drug therapy / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D012307:Risk Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors