Abstract 11717: Statin Therapy Improves Survival in Patients With Severe Pulmonary Hypertension: A Propensity Score Matching Study
Background: Efficacy of statins in improving pulmonary hypertension (PH) and reversing right ventricular hypertrophy has been demonstrated in animal models. They were also shown to reduce pulmonary arterial pressure and improve biomarkers in humans. However, clinical relevance and survival benefit of these findings in patients with PH are unknown.
Methods: From January 2002 to August 2012, transthoracic echocardiograms from 3 hospitals of Montefiore Medical Center were reviewed; all consecutive patients with age ≥18 years, severe PH (pulmonary artery systolic pressure ≥60 mmHg) and preserved left ventricular function (ejection fraction ≥50%) were included. Patients were divided into two groups based on whether or not they were on a statin for 12 consecutive months after diagnosis of PH. Propensity score matching including all baseline demographics, comorbidities, labs, lipid profile, and medications with ratio matching of 1 (treated) to 5 (untreated controls) was performed to adjust for differences in baseline characteristics. Study endpoint was 1-year all-cause mortality.
Results: Of 2,363 patients included (age 71±16; 31% male), 140 (6%) patients were on statin therapy. One-year mortality was 34% in entire population. After propensity score matching, outcome was compared between 137 patients on statin and 625 on no statin (controls). One-year all-cause mortality was significantly lower in statin compared to no-statin group (15.3% vs 36.2%, HR 0.38 [95% CI 0.25, 0.60], p<0.001). In multivariate analysis adjusted for all baseline characteristics, statin therapy remained an independent predictor of lower 1-year mortality (p<0.001).
Conclusions: In a multicenter propensity score matching study, we demonstrated for the first time, that statin therapy improves survival by reducing one-year all-cause mortality in patients with severe PH. These novel findings need to be confirmed in large randomized trials.
Author Disclosures: M. Mojadidi: None. D. Goodman-Meza: None. K. Khosraviani: None. M. Pamerla: None. R. Zolty: None.
- © 2014 by American Heart Association, Inc.