Format

Send to

Choose Destination
Eur Heart J. 2015 Jun 21;36(24):1536-46. doi: 10.1093/eurheartj/ehv072. Epub 2015 Mar 23.

The effect of statin therapy on heart failure events: a collaborative meta-analysis of unpublished data from major randomized trials.

Author information

1
BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK david.preiss@glasgow.ac.uk.
2
BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
3
Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
4
Glasgow Clinical Research Facility, Western Infirmary, Glasgow, UK.
5
George Institute for Global Health, University of Oxford, Oxford, UK.
6
Medical Research Institute, University of Dundee, Dundee, UK.
7
Department of Medicine, University of California, San Francisco, CA, USA.
8
SUNY Health Science Center at Brooklyn, New York, NY, USA.
9
Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France.
10
University of Oslo and Centre for Preventative Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.
11
University of Helsinki and Heart and Lung Center, Helsinki University Central Hospital and Folkhälsan Research Center, Helsinki, Finland.
12
Jacksonville Center for Clinical Research, Jacksonville, FL, USA.
13
International Center for Circulatory Health, National Heart & Lung Institute, Imperial College London, London, UK.
14
Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
15
The University of Texas School of Public Health, Houston, TX, USA.
16
Mitsukoshi Health and Welfare Foundation, Shinjuku-ku, Tokyo, Japan.
17
Department of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
18
Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy.
19
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
20
Weill Cornell Medical College, New York, NY, USA.
21
College of Osteopathic Medicine, Touro University, Vallejo, CA, USA.
22
Department of Medicine, University of Texas Health Science Center, San Antonio, TX, USA The South Texas Veterans Health Care System, San Antonio, TX, USA.

Abstract

AIMS:

The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events.

METHODS AND RESULTS:

We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- and secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring <30 days after within-trial myocardial infarction (MI) were excluded. We calculated risk ratios (RR) with fixed-effects meta-analyses. In up to 17 trials with 132 538 participants conducted over 4.3 [weighted standard deviation (SD) 1.4] years, statin therapy reduced LDL-cholesterol by 0.97 mmol/L (weighted SD 0.38 mmol/L). Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84-0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95% CI 0.85-0.99) but not HF death (213/57 734 vs. 220/57 836; RR 0.97, 95% CI 0.80-1.17). The effect of statins on first non-fatal HF hospitalization was similar whether this was preceded by MI (RR 0.87, 95% CI 0.68-1.11) or not (RR 0.91, 95% CI 0.84-0.98).

CONCLUSION:

In primary- and secondary-prevention trials, statins modestly reduced the risks of non-fatal HF hospitalization and a composite of non-fatal HF hospitalization and HF death with no demonstrable difference in risk reduction between those who suffered an MI or not.

KEYWORDS:

Heart failure; Meta-analysis; Prevention; Randomized trial; Statin

Comment in

PMID:
25802390
PMCID:
PMC4769322
DOI:
10.1093/eurheartj/ehv072
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center