Author + information
- Ken Chin,
- Christopher Reid,
- Andrew Tonkin,
- Ingrid Hopper,
- Angela Brennan,
- Stephen Duffy,
- David Clark,
- Andrew Ajani and
- Danny Liew
Background: The effectiveness of statins in improving clinical outcomes among high risk patients with heart failure (HF) undergoing percutaneous coronary intervention (PCI) in ‘real world’ clinical practice remains unclear. We examined the association between use of statins and clinical outcomes in HF patients included in the Melbourne Interventional Group (MIG) registry.
Methods: We performed a ‘landmark analysis’ from the time of 30-day post PCI, evaluating a primary composite outcome of all-cause mortality and hospitalisation for cardiovascular causes at 1 year. Secondary outcomes were major adverse cardiac events (MACE, a composite of all-cause mortality, myocardial infarction and target vessel revascularisation) and hospitalisations for cardiovascular causes. Multiple imputation by chained equation was performed to account for missing data. An average propensity score derived from 37 covariates and 40 imputed datasets was used to match patients taking and not taking statins in 1:1 ratio. Outcomes were also assessed by Kaplan-Meier analyses and multivariable Cox proportional-hazards models.
Results: Data from 991 patients were analysed. In the propensity score-unmatched cohort, both groups had similar rates of primary outcomes (27.2% vs 25.3%; adjusted hazard ratio[aHR] 1.757 [95% confidence interval [CI] 0.633 to 4.872]; P = 0.278), MACE (13.0% vs 12.6%; aHR, 0.370 [95% CI, 0.090 to 1.521]; P = 0.168) and hospitalisation for cardiovascular causes (26.8% vs 24.2%; aHR 1.159 [95% CI 0.404 to 3.327]; P = 0.783). In the propensity score-matched cohort, statins were associated with a poorer primary outcome (probability of event 26.8% vs 7.6%; risk difference, 19.1% [95% CI 1.5% to 36.7%]; P = 0.027) and hospitalisation for CV causes (probability of event 26.4% vs 7.6%; risk difference, 18.8% [95% CI, 1.16% to 36.4%]; P = 0.028). but not MACE (probability of event, 12.0% vs 17.9%; risk difference, −5.9% [95% CI −17.7% to 6.2%]; P = 0.828)
Conclusions: At 1 year follow-up, the use of statins in HF patients undergoing PCI was associated with higher risk of primary outcomes and hospitalisation for CV causes. However, the results may be influenced by “healthy user bias”.
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: 1121-254
- 2017 American College of Cardiology Foundation