Introduction Many theories and clinical trials have attempted to address the effect of low-density lipoprotein (LDL) lowering in chronic congestive heart failure (CHF). Several studies have demonstrated that higher lipid and lipoprotein levels, including total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides, are associated with significantly improved outcomes in HF of both ischemic and nonischemic etiologies.
Hypothesis In light of the association between high cholesterol levels and improved survival in HF, statin or other lipid-lowering therapy in HF remains controversial. In this study we evaluated the outcome of statins use in HF patients.
Method We performed a retrospective chart analysis of 1,616 patients who were admitted to the hospital from 2005 to 2012 due to decompensated HF. 781 patients had HFrEF and 780 patients had HFpEF. The medications of all patients with HFrEF and HFpEF were reviewed. Each of HFrEF and HFpEF patients were divided into two groups: Statin-treated and non-Statin treated. The 30-day readmission rate, mortality rate and LOS were subsequently determined.
Results Of the 1616 patients with decompensated HF, 776 patients had heart failure with preserved ejection fraction [HFpEF] and 780 patients had HFrEF. After the medications for each group were standardized, the 30-day readmission rate and mortality rate in the HFpEF versus HFrEF groups who received statin therapy did not differ (p=0.9 and 0.3, respectively).
The HFpEF patients who received statin therapy had a lower mortality rate comparing to the non-statin therapy group (OR: 0.2, 95% CI: 0.1–0.5, p<0.001). Furthermore, LOS was significantly lower in the HFpEF statin therapy group 5.4 days versus 6.8 days in the HFpEF non-statin group (p<0.001). 30-day readmission rate did not differ between the two groups (p=0.9).
The HFrEF patients who received statin therapy had a lower mortality rate comparing to HFrEF patients who did not receive statin therapy (OR: 0.3, 95% CI: 0.1–0.6, p<0.001). Additionally, LOS was significantly lower in the HFrEF statin therapy group 5.4 days versus 7 days in the HFrEF non-statin therapy group (p=0.04). 30-day readmission rate did not differ between the two groups (p=0.9).
Conclusion Our study showed that statin therapy was associated with both a lower mortality rate and LOS among both HFpEF and HFrEF patients. However, the benefit of statin use on 30-day readmission rate did not differ between the two groups of HF patients.
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