title: Lipophilic Statin Versus Rosuvastatin (Hydrophilic) Treatment for Heart Failure: a Meta-Analysis and Adjusted Indirect Comparison of Randomised Trials.
abstract: OBJECTIVE
  This study aims to compare lipophilic and hydrophilic statin therapy on clinical outcomes of heart failure (HF) using a systematic review and an adjusted indirect comparison meta-analysis. Outcomes were all-cause mortality, cardiovascular mortality, cardiovascular hospitalization and hospitalization for worsening HF.
  
  
  METHODS
  We conducted a search of PubMed, EMBASE and Cochrane databases until 31st December 2014 for randomized control trials (RCTs) in HF evaluating statins versus placebo. Identified RCTs and their respective abstracted information were grouped according to statin type evaluated and analyzed separately. Outcomes were initially pooled with the Peto's one-step method, producing odd ratios (OR) and 95 % confidence intervals (CI) for each statin type. Using these pooled estimates, we performed adjusted indirect comparisons of lipophilic versus hydrophilic statin for each outcome.
  
  
  RESULTS
  Thirteen studies involving 10,966 patients were identified and analyzed. Lipophilic statins were superior to hydrophilic rosuvastatin regarding all-cause mortality (OR 0 · 50; 95 % CI, 0 · 11-0 · 89; p = 0 · 01), cardiovascular mortality (OR 0 · 61; 0 · 25-0 · 97; p = 0 · 009), and hospitalization for worsening HF (OR 0 · 52; 0 · 21-0 · 83; p = 0 · 0005). However, both statins were comparable with regards to cardiovascular hospitalization [OR 0 · 80 (0 · 31, 1 · 28); p = 0 · 36].
  
  
  CONCLUSIONS
  Lipophilic statin treatment shows significant decreases in all-cause mortality, cardiovascular mortality and hospitalization for worsening HF compared with rosuvastatin treatment. This meta-analysis provides preliminary evidence that lipophilic statins offer better clinical outcomes in HF till data from head to head comparisons are available.
authors.affiliation: School of Medicine and Health Sciences, Monash University, Sunway Campus, Jalan Lagoon Selatan, Bandar Sunway, 46150, Selangor DE, Malaysia. kose1@student.monash.edu.|Pharmacy Department, Accident and Emergency Directorate, Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, Ghana. kose1@student.monash.edu.
authors.forename: Kwadwo Osei
authors.initials: KO
authors.lastname: Bonsu
authors.affiliation: School of Medicine and Health Sciences, Monash University, Sunway Campus, Jalan Lagoon Selatan, Bandar Sunway, 46150, Selangor DE, Malaysia.
authors.forename: Daniel Diamond
authors.initials: DD
authors.lastname: Reidpath
authors.affiliation: School of Medicine and Health Sciences, Monash University, Sunway Campus, Jalan Lagoon Selatan, Bandar Sunway, 46150, Selangor DE, Malaysia.
authors.forename: Amudha
authors.initials: A
authors.lastname: Kadirvelu
mesh_terms: D006333:Heart Failure / Q000188:drug therapy*; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000068718:Rosuvastatin Calcium / Q000627:therapeutic use
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000068718:Rosuvastatin Calcium
keywords: Adjusted indirect comparison; Heart failure; Hydrophilic statin; Lipophilic statin; Meta-analysis; Rosuvastatin