Does Statin Benefits Patients with Heart Failure Undergoing Percutaneous Coronary Intervention? Findings from the Melbourne Interventional Group Registry
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The effectiveness of statins in improving clinical outcomes among patients with heart failure (HF) undergoing percutaneous coronary intervention (PCI) is unclear. We examined the association between use of statins and clinical outcomes in patients with HF included in the Melbourne Interventional Group registry.
Patients were followed from 30 days to 1 year post-PCI for a primary composite outcome of all-cause mortality and hospitalisation for cardiovascular (CV) causes. Secondary outcomes included major adverse cardiac events (MACE, a composite of all-cause mortality, myocardial infarction and target vessel revascularisation) and hospitalisation for CV causes. Outcomes were compared between statin-treated and non-statin-treated patients (at 30 days post-PCI) using propensity scores to balance for risk factors.
Among 991 patients included in the inverse probability-weighted Cox model, statin use had no significant effect on the primary composite outcome [adjusted hazard ratio (aHR), 1.03; 95% confidence interval (CI), 0.68 to 1.56; p = 0.89], nor MACE (aHR, 0.99; 95% CI, 0.54 to 1.84; p = 0.99) or hospitalisation for CV causes (HR, 1.13; 95% CI, 0.74 to 1.72; p = 0.57).
Our results suggest that statin therapy may confer no significant benefits in patients with HF undergoing PCI. However, prospective randomised controlled trials are needed to provide more definitive answers.
KeywordsHeart failure Percutaneous coronary intervention Statins Propensity score Registry
KLC receives a PhD scholarship from the Ministry of Education, Malaysia. This work was supported by a NHMRC Program Grant (1092642) awarded to CMR. CMR is supported by a Research Fellowship (1045862) from the National Health and Medical Research Council of Australia (NHMRC). IH is supported by a National Health and Medical Research Council Early Career Fellowship (1113314). SJD’s work is supported by NHMRC grants.
The Melbourne Interventional Group acknowledges funding from Abbott, Astra-Zeneca, Biotronik, Boston Scientific, Bristol-Myers Squibb, Cordis Johnson & Johnson, CSL, Medtronic, MSD, Pfizer, Sanofi-Aventis, Servier, Schering-Plough and The Medicines Company. The funding bodies had no role in the design and conduct of the study, the collection, management, analysis and interpretation of the data, or the preparation, review or approval of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
This study was approved by the Alfred Hospital Ethics Committee (107/16) and Monash University Human Research Ethics Committee (CF16/841 – 2016000420).
The registry employed an ‘opt-out’ informed consent which requires patient to sign a declaration only if they refuse to contribute their relevant information, or do not want to be followed up beyond the coronary intervention.
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