Abstract 2944: Is Statin-Lipid Lowering Therapy Efficacious in Heart Failure? Insight from a Cohort Study
Context Lipid lowering therapy (LLT) reduces the risk of cardiovascular mortality. While statins are beneficial in coronary artery disease, the leading cause of ventricular dysfunction, there is uncertainty about their efficacy in heart failure (HF), including those without coronary artery stenosis.
Objective To study whether LLT is associated with improved survival in persons with HF, with or without concomitant coronary artery stenosis.
Methods Prospective cohort study of the entire province of Alberta, Canada. Among the 6,060 persons with heart failure who underwent coronary angiography over a seven-year period, 1,216 persons were receiving LLT at angiography and 4,844 were not. We estimated the risk of all-cause mortality using a multivariate Cox proportional hazard model.
Results At baseline angiography, participant mean age was 68 years and one third were women. After a median follow-up period of 4.7 years, 7.1 deaths per 100 person-years arose among LLT users, compared to 7.8 per 100 person-years among non-users. After adjusting for multiple factors, including the propensity for use of LLT and ventricular function, the hazard ratio for all-cause mortality associated with use of LLT was 0.87 (95% CI 0.77– 0.97). Adjusted HR were 0.75 (95% CI 0.49–1.2) and 0.88 (95% CI 0.78 – 0.99) in persons with less than, or greater than, 50% stenosis of one or more coronary arteries.
Conclusion Use of LLT is associated with a reduced risk of death in persons with HF. Current evidence supports statin use in persons with recognized HF and concomitant coronary artery disease, dyslipidemia or diabetes mellitus. More data are needed before they can be recommended in persons with isolated HF.