Prior statin therapy was associated with a 4.3% absolute risk reduction in acute heart failure on admission (RR 0.72) among patients presenting with acute coronary syndromes.
Cohort (n=14,542)
Sí
Does previous statin therapy reduce the incidence of acute heart failure and 30-day mortality in patients presenting with a first acute coronary syndrome?
Prior statin use is associated with a reduced risk of acute heart failure on admission and improved 30-day survival among patients presenting with their first acute coronary syndrome.
Estimación del efecto: RR 0.72 (95% CI 0.62 to 0.83)
BACKGROUND There is uncertainty regarding the impact of statins on the risk of atherosclerotic cardiovascular disease (ASCVD) and its major complication, acute heart failure (AHF). OBJECTIVES The aim of this study was to investigate whether previous statin therapy translates into lower AHF events and improved survival from AHF among patients presenting with an acute coronary syndrome (ACS) as a first manifestation of ASCVD. METHODS Data were drawn from the International Survey of Acute Coronary Syndromes Archives. The study participants consisted of 14,542 Caucasian patients presenting with ACS without previous ASCVD events. Statin users before the index event were compared with nonusers by using inverse probability weighting models. Estimates were compared by test of interaction on the log scale. Main outcome measures were the incidence of AHF according to Killip class and the rate of 30-day all-cause mortality in patients presenting with AHF. RESULTS Previous statin therapy was associated with a significantly decreased rate of AHF on admission (4.3% absolute risk reduction; risk ratio RR: 0.72; 95% CI: 0.62-0.83) regardless of younger (40-75 years) or older age (interaction P = 0.27) and sex (interaction P = 0.22). Moreover, previous statin therapy predicted a lower risk of 30-day mortality in the subset of patients presenting with AHF on admission (5.2 % absolute risk reduction; RR: 0.71; 95% CI: 0.50-0.99). CONCLUSIONS Among adults presenting with ACS as a first manifestation of ASCVD, previous statin therapy is associated with a reduced risk of AHF and improved survival from AHF. (International Survey of Acute Coronary Syndromes ISACS Archives; NCT04008173).
“I see patients with diabetes on a regular basis, and I recommend statin therapy to everyone who is eligible. Some people refuse because they want to first try lifestyle interventions or other drugs. But other interventions are not as effective at lowering cholesterol as starting statin therapy as soon as possible. Time is of the essence for your heart and brain health.”
Bugiardini et al. (Sun,) conducted a cohort in Acute coronary syndromes (n=14,542). Statin therapy vs. Statin nonusers was evaluated on Incidence of acute heart failure on admission (RR 0.72, 95% CI 0.62 to 0.83). Prior statin therapy was associated with a 4.3% absolute risk reduction in acute heart failure on admission (RR 0.72) among patients presenting with acute coronary syndromes.
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