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CORONA: Statin therapy reduced risk for recurrent HF hospitalizations
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New data from the CORONA trial suggest that patients with chronic HF treated with rosuvastatin have a reduced risk for recurrent HF hospitalization compared with patients treated with placebo.
Researchers analyzed data from the CORONA trial on 5,011 patients aged at least 60 years with chronic NYHA functional class II to IV systolic HF resulting from ischemia who were randomly assigned rosuvastatin (Crestor, AstraZeneca) or placebo.
There were 2,408 hospitalizations for HF. One or more HF hospitalizations were recorded in 1,291 patients, 750 of whom had a single HF hospitalization only.
The researchers calculated an HF hospitalization rate of 52 per 100 patients in the placebo group and 44.1 per 100 patients in the rosuvastatin group, or 21 per 100 patient-years and 17.7 per 100 patient-years, respectively (rate ratio [RR]=0.84; 95% CI, 0.78-0.92). The relative risk of experiencing at least one HF-related hospitalization was 0.92 (95% CI, 0.84-1.01) among statin vs. placebo recipients.
Conventional assessment of time-to-first event analysis indicated a nonsignificant reduction in risk for HF hospitalization among statin recipients (HR=0.91; 95% CI, 0.82-1.02). However, analysis via a negative binomial regression model yielded a significantly reduced RR of 0.82 (95% CI, 0.72-0.92) among statin recipients vs. placebo for HF-related hospitalization, after adjustment for baseline confounders.
Similar results were observed for CV-related hospitalization, including HF and other issues (adjusted RR=0.83; 95% CI, 0.76-0.91), as well as all-cause hospitalization (adjusted RR=0.89; 95% CI, 0.83-0.96). The inclusion of CV-related death along with recurrent HF hospitalization also did not alter results (adjusted RR=0.85; 95% CI, 0.77-0.94). A joint frailty model yielded an estimated adjusted RR of 0.82 (95% CI, 0.73-0.92) for HF hospitalization with statin use vs. placebo, with similar risk for CV-related death between the groups (adjusted HR=0.94; 95% CI, 0.82-1.09).
“In this retrospective analysis, we found evidence that treatment with rosuvastatin causes a highly significant reduction in the overall incidence of hospitalizations for worsening HF in the CORONA trial, although the effect size was modest,” the researchers wrote. “… This benefit is potentially clinically worthwhile and should lead to further investigation of the role of statins in ischemic systolic HF.”
Disclosure: See the full study for a list of relevant financial disclosures.
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