Abstract 2704: Effect Of Statin Treatment On Long-Term Clinical outcome In Patients With End-Stage Heart Failure
Introduction: Statin treatment has a major impact on clinical outcome in patients with atherosclerosis, but its role in patients with end-stage heart failure is controversial, since low LDL is associated with worse clinical outcome in these patients. We examined the effect of statin treatment on the long-term clinical outcome of patients with end-stage heart failure.
Methods: The study population consisted of 250 patients (57.9±1.1 yrs old) with end-stage heart failure (NYHA IV, ejection fraction of the left ventricle 34±0.2%). At baseline, 127 patients were treated with statins while 123 patients not receiving any hypolipidemic agent were selected to be matched to the treated group according to age, gender and risk factors for atherosclerosis. Participants were followed-up prospectively for 18 months, and cardiovascular death was used as the main end-point. Cox-regression was performed to determine the impact of statin treatment of survival in these patients.
Results: During the follow-up period, 167(66.8%) cardiovascular deaths were reported. The hazard ratio[95%CI] for cardiovascular death, was 1.494[1.028–2.173], p=0.036 for those not receiving statins vs those treated with statins (Figure⇓). This effect was comparable to that of angiotensin converting enzyme inhibitors (HR[95%CI]:1.464[1.019–2.103], p=0.039].
Conclusion: Treatment with statins significantly decreases the hazard ratio for cardiovascular death in patients with end-stage severe heart failure. This finding suggests that statin treatment on top of standard medication, may be beneficial in this group of patients, since it improves their long-term survival .