Reduced Heart Failure and Mortality in Patients Receiving Statin Therapy Before Initial Acute Coronary Syndrome
Por:
Bugiardini, R, Yoon, J, Mendieta, G, Kedev, S, Zdravkovic, M, Vasiljevic, Z, Milicic, D, Manfrini, O, van der Schaar, M, Gale, CP, Bergami, M, Badimon, L, Cenko, E
Publicada:
24 may 2022
Ahead of Print:
1 may 2022
Resumen:
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. (C) 2022 by the American College of Cardiology Foundation.
Filiaciones:
Bugiardini, R:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Bologna, Italy
Yoon, J:
Google Cloud AI, Sunnyvale, CA USA
Univ Calif Los Angeles, Dept Elect & Comp Engn, Los Angeles, CA USA
Mendieta, G:
Ctr Nacl Invest Cardiovasc Carlos III CNIC, Madrid, Spain
Kedev, S:
Ss Cyril & Methodius Univ, Univ Clin Cardiol, Fac Med, Skopje, North Macedonia
Zdravkovic, M:
Univ Hosp Med Ctr Bezanijska Kosa, Belgrade, Serbia
Vasiljevic, Z:
Univ Belgrade, Fac Med, Belgrade, Serbia
Milicic, D:
Univ Zagreb, Univ Hosp Ctr Zagreb, Dept Cardiovasc Dis, Zagreb, Croatia
Manfrini, O:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Bologna, Italy
van der Schaar, M:
Univ Calif Los Angeles, Dept Elect & Comp Engn, Los Angeles, CA USA
Univ Cambridge, Cambridge Ctr Artificial Intelligence Med, Dept Appl Math & Theoret Phys, Cambridge, England
Univ Cambridge, Dept Populat Hlth, Cambridge, England
Gale, CP:
Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Leeds, W Yorkshire, England
Bergami, M:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Bologna, Italy
Badimon, L:
CiberCV Inst Carlos III, Cardiovasc Res Program ICCC, Hosp Santa Creu & St Pau, IR IIB St Pau, Barcelona, Spain
Cenko, E:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Bologna, Italy
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