Observational Study

. 2022 May 24;79(20):2021-2033.

doi: 10.1016/j.jacc.2022.03.354.

Reduced Heart Failure and Mortality in Patients Receiving Statin Therapy Before Initial Acute Coronary Syndrome

Affiliations

¹ Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy. Electronic address: raffaele.bugiardini@unibo.it.
² Google Cloud AI, Sunnyvale, California, USA; Department of Electrical and Computer Engineering, University of California, Los Angeles, Los Angeles, California, USA.
³ Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
⁴ University Clinic of Cardiology, Faculty of Medicine Ss. Cyril and Methodius University, Skopje, Macedonia.
⁵ University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia.
⁶ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
⁷ Department of Cardiovascular Diseases, University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia.
⁸ Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy.
⁹ Department of Electrical and Computer Engineering, University of California, Los Angeles, Los Angeles, California, USA; Cambridge Centre for Artificial Intelligence in Medicine, Department of Applied Mathematics and Theoretical Physics and Department of Population Health, University of Cambridge, Cambridge, United Kingdom.
¹⁰ Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
¹¹ Cardiovascular Research Program ICCC, IR-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, CiberCV-Institute Carlos III, Barcelona, Spain.

PMID: 35589164
DOI: 10.1016/j.jacc.2022.03.354

Free article

Observational Study

Reduced Heart Failure and Mortality in Patients Receiving Statin Therapy Before Initial Acute Coronary Syndrome

Raffaele Bugiardini et al. J Am Coll Cardiol. 2022.

Free article

. 2022 May 24;79(20):2021-2033.

doi: 10.1016/j.jacc.2022.03.354.

Authors

Affiliations

¹ Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy. Electronic address: raffaele.bugiardini@unibo.it.
² Google Cloud AI, Sunnyvale, California, USA; Department of Electrical and Computer Engineering, University of California, Los Angeles, Los Angeles, California, USA.
³ Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
⁴ University Clinic of Cardiology, Faculty of Medicine Ss. Cyril and Methodius University, Skopje, Macedonia.
⁵ University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia.
⁶ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
⁷ Department of Cardiovascular Diseases, University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia.
⁸ Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy.
⁹ Department of Electrical and Computer Engineering, University of California, Los Angeles, Los Angeles, California, USA; Cambridge Centre for Artificial Intelligence in Medicine, Department of Applied Mathematics and Theoretical Physics and Department of Population Health, University of Cambridge, Cambridge, United Kingdom.
¹⁰ Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
¹¹ Cardiovascular Research Program ICCC, IR-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, CiberCV-Institute Carlos III, Barcelona, Spain.

PMID: 35589164
DOI: 10.1016/j.jacc.2022.03.354

Abstract

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).

Keywords: 30-day mortality; acute heart failure; atherosclerotic cardiovascular disease; statins.

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Conflict of interest statement

Funding Support and Author Disclosures EMMACE was funded by the National Institute for Health Research and the British Heart Foundation. Dr Gale has received personal fees from AstraZeneca, Amgen, Bayer, and Daiichi-Sankyo outside the submitted work; and has received grants from Abbott and Bristol Myers Squibb outside the submitted work. Dr Badimon has served on the Scientific Advisory Board for Bayer; has served on the Scientific Advisory Board for and received personal fees and speaker fees from the International Aspirin Foundation during the conduct of the study; has served on the Scientific Advisory Board for Sanofi and Glycardial; has received personal fees from Lilly, AstraZeneca, BMS/Pfizer, and PACE; has received grants from AstraZeneca; has received personal fees and other from FICYE (Forum to Study Beer & Lifestyle), outside the submitted work; and has a patent APOj-Gly licensed, a patent IV_STATIN pending, and a patent DJ1-F pending. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Comment in

Registry Evidence for Modulation of the Acute Ischemic Heart Disease Pathway: Statins Prevent Heart Failure?
Schocken DD. Schocken DD. J Am Coll Cardiol. 2022 May 24;79(20):2034-2036. doi: 10.1016/j.jacc.2022.03.343. J Am Coll Cardiol. 2022. PMID: 35589165 No abstract available.

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Reduced Heart Failure and Mortality in Patients Receiving Statin Therapy Before Initial Acute Coronary Syndrome

Affiliations

Reduced Heart Failure and Mortality in Patients Receiving Statin Therapy Before Initial Acute Coronary Syndrome

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

Publication types

MeSH terms

Substances

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical