The effect of statin therapy on heart failure events: a collaborative meta-analysis of unpublished data from major randomized trials

Preiss, D. et al. (2015) The effect of statin therapy on heart failure events: a collaborative meta-analysis of unpublished data from major randomized trials. European Heart Journal, 36(24), pp. 1536-1546. (doi: 10.1093/eurheartj/ehv072) (PMID:25802390) (PMCID:PMC4769322)

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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 Collaborating trialists provided unpublished data from adverse event reports.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.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Preiss, Dr David and Packard, Professor Chris and Murray, Mrs Heather and Sattar, Professor Naveed and Campbell, Dr Ross and McMurray, Professor John and Ford, Professor Ian
Authors: Preiss, D., Campbell, R. T., Murray, H. M., Ford, I., Packard, C. J., Sattar, N., Rahimi, K., Colhoun, H. M., Waters, D. D., LaRosa, J. C., Amarenco, P., Pedersen, T. R., Tikkanen, M. J., Koren, M. J., Poulter, N. R., Sever, P. S., Ridker, P. M., MacFadyen, M. J., Solomon, S. D., Davis, B. R., Simpson, L. M., Nakamura, H., Mizuno, K., Marfisi, R. M., Marchioli, R., Tognoni, G., Athyros, V. G., Ray, K. K., Gotto, A. M., Clearfield, M. B., Downs, J. R., and McMurray, J. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Heart Journal
Journal Abbr.:Eur. heart j.
Publisher:Oxford University Press
ISSN (Online):1522-9645
Published Online:25 March 2015
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in European Heart Journal 36(24):1536-1546
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
615391Palliative Care Needs in Patients with Heart FailureJohn McmurrayBritish Heart Foundation (BHF)PG/13/17/30050RI CARDIOVASCULAR & MEDICAL SCIENCES