Revista argentina de cardiología
versión On-line ISSN 1850-3748
ZAMBRANO, Carola et al. Statin Treatment In Chronic Heart Failure GESICA Registry. Rev. argent. cardiol. [online]. 2005, vol.73, n.4, pp. 264-270. ISSN 1850-3748.
Background Statins have shown to be effective in reducing in coronary events, but their prognostic effect in heart failure (HF) is unknown. Research Design and Methods A cohort of 2331 outpatients was analyzed. Statin therapy status was established at baseline. Clinical characteristics between treated and untreated patients were compared. The incidence of events (mortality and HF admission) was compared between groups using log-rank test and the effect estimates were adjusted for confounders using Cox regression. Results Mean follow-up was 957 days. Statin use at baseline was 8.7%. The group treated with statins showed a higher prevalence of: male sex (78.4% vs. 70.9%, p = 0.02), ischemic myocardiopathy (72.2% vs. 37.6% p< 0.0001), dyslipemia (85.1% vs. 9.4% p< 0.001), systolic dysfunction (87.5% vs. 81.6% p = 0.03), and a lower prevalence of COPD (5.2% vs. 9.8% p = 0.03), NYHA FC III-IV (38.7% vs. 53.4% p< 0.0001) than the group not treated with statins, respectively. Mortality was lower in the statins group: 16.1% vs. 26.8%, RR 0.55, 95% CI 0.38-0.77, p = 0.001. Multivariate analysis: HR 0.62, 95% CI 0.43-0.89, p = 0.009. The benefit was observed both in patients with (HR 0.61, 95% CI 0.45-0.82, p = 0.001) and without (HR 0.65 95% CI 0.41-1.0, p = 0.05, p for interaction = 0.85) ischemic myocardiopathy. Patients treated with statins showed a non-significant lower risk of admission due to HF: 22.4% vs. 25.7%, p = 0.07. Conclusions Statins could be beneficial in HF through diverse mechanisms. Our results and other observational studies seem to indicate that statins reduce mortality and morbidity in heart failure. This hypothesis needs to be confirmed through well designed randomized controlled clinical trials.
Palabras clave : Congestive heart failure; Statins; Mortality.