Statins Improve Survival in Elderly Heart Failure Patients

Statin therapy was tied to a 28% reduction in risk.

Statin therapy is associated with a reduction in mortality in elderly patients recently diagnosed with congestive heart failure (CHF), researchers in Canada report. However, randomized trial data are needed before such therapy can be recommended for all CHF patients.

"Statins have been shown to be beneficial in patients with coronary artery disease, but their value in patients with CHF has been unknown," lead author Dr. Joel G. Ray, from St. Michael’s Hospital in Toronto, told Reuters Health. "In our study, we decided to see if statin therapy protects elderly CHF patients from death, MI, or stroke."

The retrospective cohort study involved 28,828 elderly patients with newly diagnosed heart failure. Of these subjects, 1146 were given statin therapy and 27,682 were not.

During 7 years of follow-up, the rate of death, MI, or stroke among statin users was 13.6 per 100 person-years, much lower than the rate among non-users (21.8 per 100 person-years). Thus, statin therapy was tied to a 28% reduction in the risk of this combined endpoint.

Further analysis revealed that the reduction in the combined endpoint was mainly due to a 33% decline in all-cause mortality. Although reduced rates of MI and stroke were seen among statin users, the reductions fell short of statistical significance.
While it would be tempting to conclude that all patients with heart failure should receive statin therapy, Dr. Ray said that the data to support this practice are not yet available. He cited cost rather than safety issues as the main reason why clinicians should not simply give statins to all CHF patients.

Still, Dr. Ray noted that about 70% of CHF patients have other conditions for which statin therapy is already indicated. So, the question of who should get these agents "really centers on the smaller percentage of patients with isolated heart failure," he added.

An answer to this question may come in a few years after a randomized trial called CORONA is completed, Dr. Ray said.
Arch Intern Med 2005;165:62-67.