Statin use was associated with reduced mortality in both ischemic and nonischemic cardiomyopathy and in patients with implantable defibrillators: Mortality data and mechanistic insights from the S udden C ardiac D eath in He art F ailure T rial (SCD-HeFT)

• Published in: The American heart journal 2007, Vol.153 (4), p.573-578
• Main Authors: Dickinson, Michael G., MD, Ip, John H., MD, FACC, Olshansky, Brian, MD, FACC, Hellkamp, Anne S., MS, Anderson, Jill, RN, Poole, Jeanne E., MD, FACC, Mark, Daniel B., MD, MPH, FACC, Lee, Kerry L., PhD, Bardy, Gust H., MD, FACC
• Format: Article
• Language: English
• Subjects: Cardiovascular
• ISSN: 0002-8703
• DOI: 10.1016/j.ahj.2007.02.002

Background Recent observations suggest statin treatment may be associated with lower mortality in heart failure (HF). The SCD-HeFT was a study of 2521 functional class II and III HF patients with left ventricular ejection fractions ≤35% and ischemic and nonischemic cardiomyopathy followed up for a median of 45.5 months. The study length, size, and degree of background HF, including the use of implantable defibrillator therapy, provide a unique opportunity to evaluate the impact of statin use in HF with mechanistic insights from subgroup analyses. Methods and Results Statin use was reported in 965 (38%) of 2521 patients at baseline and 1187 (47%) at last follow-up. The relationships between statin use, randomization arm, disease category, and functional class and all cause mortality were assessed. Statin use was studied as a time-dependent covariate in a multivariable Cox proportional hazards model, adjusted for imbalances between statin and no-statin groups. Mortality risk was significantly lower in those taking a statin (HR [95% CI], 0.70 [0.58-0.83]). Mortality risk was lower with statin use in all prespecified subgroups: ischemic cardiomyopathy (0.69 [0.56-0.86]), nonischemic cardiomyopathy (0.67 [0.47-0.96]), implantable cardioverter defibrillator (ICD) (0.66 [0.46-0.95], non-ICD (0.71 [0.57-0.87]), New York Heart Association II (0.62 [0.48-0.79]), and New York Heart Association III (0.79 [0.61-1.03]). Conclusions Statin use is associated with reduced all-cause mortality in HF patients. Statins appear to benefit patients with nonischemic and ischemic cardiomyopathy similarly. Statin benefits are similar in ICD and non-ICD patients.