[Effect of statin therapy on mortality in patients with non-ischemic dilated cardiomyopathy].
OBJECTIVE
To explore the effect of early statin therapy (atorvastatin and simvastatin) on mortality in patients with non-ischemic dilated cardiomyopathy.


METHODS
A retrospective study was conducted at a single center. A total of 315 patients with non-ischemic dilated cardiomyopathy, admitted into our hospital from January 2002 to December 2008, were enrolled. The association of statin therapy at the initial hospitalization with all-cause mortality was evaluated. The median follow-up period was 45.1 months.


RESULTS
By the single-factor analysis, we found that the follow-up mortality was 17.2% in statin group and it was significantly lower than 37.4% of non-statin users (P = 0.003); in patients with worsening cardiac function NYHA III - IV, the mortality of statin group was 17.2% while a much higher mortality of 47.4% was found in non-statin users (P = 0.003); in patients with NYHA I - II, no significant difference was found in mortality between two groups. By the multi-factor analysis adjusting for age, gender, history of hypertension, diabetes mellitus, current cigarette smoking, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, left ventricular ejection fraction, NYHA functional class, use of angiotensin-converting enzyme inhibitor, β blocker, aldosterone, other diuretics, digoxin and calcium channel blocker, we found the relative risk (RR) of death in statin use was 0.352 (95%CI 0.135 - 0.920, P = 0.033). In patients with NYHA III - IV, the relative death risk of statin therapy was 0.250 (95%CI 0.081 - 0.778, P = 0.017).


CONCLUSIONS
Early treatment of atorvastatin or simvastatin is closely correlated with the reduction of mortality in non-ischemic dilated cardiomyopathy patients, especially in those with severe heart failure. And the correlation is independent of the lipid-lowering effects of statins, ACEI and β-blocker therapy.
Li
Xu
X
Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Science, Beijing 100029, China.
Liu
Xing-peng
XP
Liu
Xiao-hui
XH
Du
Xin
X
Kang
Jun-ping
JP
Lü
Qiang
Q
Wang
Hai-yun
HY
Xu
Xia
X
Liang
Cui
C
Yan
Qian
Q
Lei
Tao
T
Geng
Li-li
LL
Liu
Bai-qiu
BQ
Ma
Chang-sheng
CS
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors