Do statins improve heart failure outcome in post-myocardial infarction patients with moderate to severe left ventricular dysfunction?
The authors conducted this retrospective cohort study to assess the influence of statins on heart failure (HF) outcome by enrolling 500 consecutive acute myocardial infarction patients, majority (339 of 500) with moderate to severe left ventricular dysfunction (ejection fraction <40%) between March 2000 and March 2002 with 5.5-year mean follow-up. They were retrospectively analyzed according to whether they were discharged on a statin, and their HF outcome was evaluated independent of overt clinical ischemic events. Mortality in the statin group was 71 of 249 (28.5%; median survival 252 days) vs 48 of 90 (53%; median survival, 141.5 days; P<.001) in the no-statin group. Univariate analysis showed fewer HF readmissions (statin group, 7% vs no-statin group, 32%; P<.001) and HF deaths (statin group, 4% vs no-statin group, 13%; P=.002). Multivariate analysis by logistic regression showed that these effects due to statins are independent of cholesterol levels, age, sex, drugs, revascularization, and implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy. Statins have an important role in independently improving HF outcome in post-myocardial infarction patients with left ventricular ejection fraction < 40%.
Sankaranarayanan
Rajiv
R
Manchester Heart Centre, UK. rajiv-s@doctors.org.uk
Maini
Sameer
S
James
Michael Anthony
MA
Burtchaell
Stephanie
S
Chatterjee
Amit K
AK
D000368:Aged; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents