Patients with heart failure who used statins for the first time had a reduced risk of death of nearly 25 percent, compared to non-users, and also a lower risk for hospitalization, according to a study in the November 1 issue of JAMA.
Statins effectively lower low-density lipoprotein (LDL) cholesterol level. However, some studies have indicated a higher risk of adverse events in persons with heart failure and low levels of LDL cholesterol. Whether statin therapy has beneficial effects on clinical outcomes in patients with heart failure is unclear.
Alan S. Go, M.D., of Kaiser Permanente of Northern California, Oakland, Calif., and colleagues examined the association between initiation of statin therapy and risks of death and hospitalization within a large population of patients with heart failure who were eligible for lipid-lowering therapy. The study, conducted between Jan. 1996 and Dec. 2004, included 24,598 adults, of whom 51.4 percent (n = 12,648) initiated statin therapy. There was a median of 2.4 years of follow-up, during which 8,235 patients died.
The researchers found that new statin use was associated with a 24 percent lower relative risk of death (14.5 deaths per 100 person-years [the number of people in the study times the number of years of follow-up per person]) compared with not taking a statin (25.3 deaths per 100 person-years), even after adjustment for cholesterol level, use of other cardiovascular medications, and other factors. Similarly, new statin use was associated with a 21 percent lower relative risk of hospitalization for heart failure compared with no statin use. The lower rate of death and hospitalization was seen in the presence or absence of known coronary heart disease.
"… given the clinically relevant effect size associated with receipt of statins in our study, results from ongoing and future randomized controlled trials involving clinical outcomes-particularly among patients with nonischemic heart failure not otherwise recommended to receive lipid-lowering therapy-are needed to clarify the role of statins in the management of heart failure," the authors conclude.
(JAMA. 2006;296:2105-2111. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: The research for this article was funded by a grant from Amgen Inc. Dr. Go and co-author Jingrong Yang, M.A., reported receiving research support for this study from Amgen Inc. Dr. Go also reported receiving research support from Wyeth. Co-author Joan C. Lo, M.D., reported receiving research support from Novartis. None of the other authors reported disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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