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Statins may reduce risk for HF hospitalization
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Statin therapy was associated with a moderate reduction in risk for HF hospitalization and a composite of HF hospitalization and HF death, researchers reported at the Annual Congress of the European Atherosclerosis Society.
David Preiss, MD, PhD, from the Institute of Cardiovascular and Medical Sciences at the University of Glasgow, Scotland, conducted a meta-analysis of 17 statin trials covering 132,538 participants during a mean of 4.3 years to determine whether statins are linked to a reduction in major HF events. They obtained unpublished data from adverse event reports.
“While it has been assumed that statins reduce the development of [HF] simply because they reduce [MI], to our surprise this had not been definitively shown before,” Preiss said in a press release. “The results of this meta-analysis clearly show a modest, but significant benefit, reducing hospital admission for [HF] by 10%, which is clinically important.”
The outcomes of interest were first nonfatal HF hospitalization, HF death and a composite of first nonfatal HF hospitalization or HF death. The researchers excluded HF events occurring less than 30 days after within-trial MI.
In the trials analyzed, statin therapy reduced LDL by 0.97 mmol/L.
Statin therapy reduced the rate of first nonfatal HF hospitalization (1,344 of 66,238 patients assigned statins vs. 1,498 of 66,330 patients not assigned statins; RR = 0.9; 95% CI, 0.84-0.97) and the composite outcome of first nonfatal HF hospitalization or HF death (1,234 of 57,734 patients assigned statins vs. 1,344 of 57,836 patients not assigned statins; RR = 0.92; 95% CI, 0.85-0.99), according to the results.
“The 10% reduction in hospital admission for [HF] could easily be an underestimate of the true effect, given that the trials were only 4 years duration on average, and the data only related to first [HF] events,” Preiss said in the release. “With emerging data showing accrual of benefit from statins in the long-term, the 10% reduction is just the beginning of benefit from statin therapy. Additionally, if all [HF] admissions were taken into account, we suspect that the benefit would be much larger.”
However, there was no evidence that statin therapy reduced HF death (213 of 57,734 patients assigned statins vs. 220 of 57,836 patients not assigned statins; RR = 0.97; 95% CI, 0.8-1.17).
The effect of statins on first nonfatal HF hospitalization was similar regardless of whether it was preceded by MI (RR = 0.87; 95% CI, 0.68-1.11) or not preceded by MI (RR = 0.91; 95% CI, 0.84-0.98), the researchers wrote.
“It is probable that statins decrease the degree of ischemia that occurs before [MI], leading to a decrease in the number of people with other ischemic events and reducing the chronic impact on the heart,” Preiss said in the release. “However, an unrecognized pleiotropic effect cannot yet be excluded and further study of the potential mechanism(s) is needed.”
The data were simultaneously published in European Heart Journal. – by Erik Swain
References:
Preiss D, et al. Late-Breaking Session I. Presented at: 83rd Annual Congress of the European Atherosclerosis Society; March 22-25, 2015; Glasgow, Scotland.
Preiss D, et al. Eur Heart J. 2015;doi:10.1093/eurheartj/ehv072.
Disclosure: Preiss reports serving on advisory boards for Sanofi Aventis.