Effect of Statins on Mortality in Heart Failure With Preserved Ejection Fraction Without Coronary Artery Disease ― Report From the JASPER Study ―
Authors:
- 25 January 2019
- journal article
- research article
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 83 (2) , 357-367
Abstract
Background:Statins might be associated with improved survival in patients with heart failure with preserved ejection fraction (HFpEF). The effect of statins in HFpEF without coronary artery disease (CAD), however, remains unclear.Methods and Results:From the JASPER registry, a multicenter, observational, prospective cohort with Japanese patients aged ≥20 years requiring hospitalization with acute HF and LVEF ≥50%, 414 patients without CAD were selected for outcome analysis. Based on prescription of statins at admission, we divided patients into the statin group (n=81) or no statin group (n=333). We followed them for 25 months. The association between statin use and primary (all-cause mortality) and secondary (non-cardiac death, cardiac death, or rehospitalization for HF) endpoints was assessed in the entire cohort and in a propensity score-matched cohort. In the propensity score-matched cohort, 3-year mortality was lower in the statin group (HR, 0.21; 95% CI: 0.06–0.72; P=0.014). The statin group had a significantly lower incidence of non-cardiac death (P=0.028) and rehospitalization for HF (P<0.001), but not cardiac death (P=0.593). The beneficial effect of statins on mortality did not have any significant interaction with cholesterol level or HF severity.Conclusions:Statin use has a beneficial effect on mortality in HFpEF without CAD. The present findings should be tested in an adequately powered randomized clinical trial.Keywords
This publication has 49 references indexed in Scilit:
- Spironolactone for Heart Failure with Preserved Ejection FractionNew England Journal of Medicine, 2014
- Epidemiology of Heart Failure in AsiaCirculation Journal, 2013
- Heart Disease and Stroke Statistics—2013 UpdateCirculation, 2013
- Characteristics and Outcomes of Hospitalized Patients With Heart Failure and Reduced vs Preserved Ejection Fraction A Report From the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)Circulation Journal, 2009
- Irbesartan in Patients with Heart Failure and Preserved Ejection FractionNew England Journal of Medicine, 2008
- The perindopril in elderly people with chronic heart failure (PEP-CHF) studyEuropean Heart Journal, 2006
- Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection FractionNew England Journal of Medicine, 2006
- Rationale and Design of a Randomized Trial to Assess the Effects of β-blocker in Diastolic Heart Failure; Japanese Diastolic Heart Failure Study (J-DHF)Journal of Cardiac Failure, 2005
- Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved TrialThe Lancet, 2003
- Congestive heart failure in subjects with normal versus reduced left ventricular ejection fractionJACC, 1999