Author + information
- Amer Hawatmeha,b,
- Mohammad Thawabia,b,
- Habib Habiba,b,
- Firas Qaqaa,b,
- Samer Haddada,b,
- Sarah Studyvina,b,
- Fayez Shamoona,b and
- Marc Cohena,b
Background: The pathophysiological mechanism of heart failure with preserved ejection fraction (HFpEF) is multifactorial and may involve a systemic inflammatory state. Inflammation plays an important role in left ventricular remodeling and myocytes hypertrophy. The anti-inflammatory effects of statins might improve survival in this subset.
Methods: A retrospective study of 434 consecutive patients with a discharge diagnosis of acute decompensated HFpEF, not associated with acute coronary syndrome, between January 2010 and December 2013 was performed. Clinical data and medications on discharge were retrospectively abstracted from medical records. Survival status was obtained from medical records and social security death index database. Patients discharged on low, intermediate, and high intensity statins were identified. The association between statin use, intensity, and 3-year all-cause mortality were assessed using cox proportional hazards model and Kaplan-Meier estimator.
Results: Statins were prescribed to 58.3% of the patients on discharge. Low intensity statins were prescribed in 10%, moderate intensity in 60%, and high intensity in 30% of the patients discharged on statins. Patients discharged on statin therapy had a lower 3-year mortality (7.8%) when compared to patients who were not discharged on statins (20.1%, HR 0.37, 95% CI 0.21-0.64, p<0.001). After adjustment for age, sex, and race, statin therapy remained a significant independent predictor of lower 3-year mortality (HR 0.34, 95% CI 0.20-0.59, p <0.001). On assessing the relation between statin intensity and survival, patients discharged on moderate (HR 0.36, 95% CI 0.20-0.63, p=0.001) or high intensity statins (HR 0.18, 95% CI 0.09-0.36, p=0.001) had lower 3-year mortality when compared to patients who were not discharged on statins. However, high intensity statins were not superior to moderate intensity statins. Patients who were discharged on low intensity statins did not have lower 3-year mortality (p=0.75) compared to patients who were not discharged on statins.
Conclusions: The use of moderate or high intensity statins, after acute HFpEF decompensation, was associated with improved outcome.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Heart Failure and Cardiomyopathies: Is Heart Failure With a Normal EF for Real?
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1121-245
- 2017 American College of Cardiology Foundation