Abstract 2368: Utility of Statins in Heart Failure: Analysis of 10510 patients
Background: There is conflicting data regarding the mortality benefit of statins in patients with heart failure. The objectives were to determine whether statin therapy is associated with decreased all-cause mortality and to assess the effect of incremental duration of therapy.
Methods: We studied 10,510 consecutive patients from the Veterans Affairs health system with a diagnosis of heart failure from 10/01 through 12/06. Statin use and duration of therapy were identified. Logistic regression was performed to identify the association between incident statin use and all cause mortality following a diagnosis of heart failure. The Kaplan-Meier method was employed to assess for differences in survival time between the four statin use classifications based on duration of therapy (none, 1–25%, 26 –75% and > 75% use of statins).
Results: Statin use was significantly associated with decreased all cause mortality following a diagnosis of heart failure after controlling for age, gender, concurrent medications, and comorbid diagnoses (χ2 (29, N = 10510) = 1077.82, p < .001). Patients who were not exposed to statin therapy at any time during the study period were 1.56 times more likely to suffer all cause mortality during a mean follow-up of 3.5 years (Figure⇓). Analysis of Mantel-Cox pairwise comparisons indicated that survival time for the no statin use classification was significantly less in comparison to all three statin use classifications (Figure⇓).
Conclusions: Statin use was associated with decreased all-cause mortality in heart failure patients, but there was no incremental benefit on survival beyond 25% of use suggesting a pleiotropic effect of statins in heart failure patients.