Association of statin use and clinical outcomes in heart failure patients: a systematic review and meta-analysis
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Key result
Statin use was associated with a 23% lower risk of all-cause mortality (HR 0.77) compared with non-statin use in patients with heart failure.
Why the study?
The role of statins across different LVEF levels remained unclear, especially given the lack of prospective RCT data in non-ischemic HF and potential prosarcopenic effects.
Does statin use reduce all-cause mortality, cardiovascular mortality, and cardiovascular hospitalizations in patients with heart failure?
Population
88,100 patients with HF across 17 studies
Comparison
Statin vs non-statin use
Design
Systematic review and meta-analysis of RCTs and prospective cohorts
Follow-up
Mean 36 months
Authors
Discussion
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Implication
May support statin consideration in heart failure; extends observational evidence but leaves causality open pending RCTs.
Study Design
Type
Meta-Analysis (n=88,100)
Structured PICO
Does statin use reduce all-cause mortality, cardiovascular mortality, and cardiovascular hospitalizations in patients with heart failure?
P
Population
88,100 patients with heart failure (both LVEF <40% and ≥40%) pooled from 17 studies (2 RCTs and 15 prospective cohorts), mean age 67, 68% male.
I
Intervention
Statin use (including lipophilic and hydrophilic statins as a class)
C
Comparator
Non-statin use
O
Outcome
All-cause mortality, cardiovascular (CV) mortality, and CV hospitalizationhard clinical
Main Result
Effect estimate: HR 0.77 (95% CI 0.72-0.83)
p-value: p=<0.0001
Statin use in heart failure patients is associated with significantly reduced all-cause mortality, cardiovascular mortality, and cardiovascular hospitalizations, with lipophilic statins appearing more favorable.
Limitations
- Limited information available on patient characteristics such as compliance with statin therapy or statin dosage
- Included studies did not have enough data to check correlations with cholesterol level and body mass index (BMI)
- The solubility of statins was a variable that was not available in most of the trials
- Most studies were performed before 2016 when there were no fixed LVEF cut-off points for HFpEF and HFmrEF
Cite This Study
Bielecka‐Dąbrowa et al. (2019) conducted a meta-analysis in Heart failure (n=88,100). Statins vs. Non-statin use was evaluated on All-cause mortality (HR 0.77, 95% CI 0.72-0.83, p=<0.0001). Statin use was associated with a 23% lower risk of all-cause mortality (HR 0.77) compared with non-statin use in patients with heart failure.
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