Abstract 17525: Statin Use Is Associated With Better Survival in Patients with Positive Stress Tests With Negative Coronary Angiograms: Potential Beneficial Effects In Coronary Microvascular Disease
Background: Myocardial ischemia with negative coronary angiograms is not benign and carries the risk of increased hospitalization, health care costs and possibly mortality. There is a lack of therapeuic options in these patients. As statins improve coronary endothelial function, we hypothesized that statins may improve survival in these patients.
Methods: Our stress and angiographic database were screened for patients with positive stress test and negative angiograms (coronary artery diameter stenosis <50%). This yielded a total of 611 patients. Detailed chart reviews were performed for clinical, demographic and therapeutic data. Survival data was obtained from social security death index and was analyzed as a function of statin therapy.
Results: Of the 611 patients, 344 were on a statin. Statin therapy was associated with a higher survival rate compared to those without (1 and 5 year survival rates 88% and 78% compared to 72% and 60% respectively, p=0.07). Using the Cox proportional hazards model, statin therapy was a strong independent predictor of better survival (HR 0.58, 95% CI 0.36-0.86, p=0.009) after adjusting for group differences (statin versus no statin) such as age (63±10 vs. 61±12 years, p=0.08), diabetes mellitus (26% versus 23%, p=0.03), hypertension (76% versus 50%, p<0.0001) and gender (males 73 versus 54%, p=<0.0001).
Conclusions: Statin therapy is associated with an independent survival benefit in patients with positive stress test with negative coronary angiograms. Statins should be considered in such patients and this finding warrants further investigations.
- © 2010 by American Heart Association, Inc.