Prognostic Significance of Statins in Ischemic and Non-ischemic Heart Failure Patients with Reduced Ejection Fraction in Real Life

OBJECTIVE
Although the positive effects of statin therapy in cardiovascular diseases are known, current heart failure guidelines do not recommend statins. The aim of this study was to investigate the effect of statin on all-cause mortality in patients with ischemic or non-ischemic heart failure with low ejection fraction using real-life data.


METHODS
In this study, 1144 patients with heart failure with low ejection fraction were included retrospectively.


RESULTS
In the study cohort, 55.4% were ischemic heart failure patients and 42.4% of the patients were on statin therapy. The rate of patients using statins was 60.5% in the ischemic group and 20.2% in the non-ischemic group (P <.001). During the median 35-month follow-up, 337 deaths were observed. Mortality rates were similar in ischemic and non-ischemic groups (31.3% vs 26.9%, P =.092). When the statin usage status of the patients was examined, ischemic heart failure, all survivors, and survivors with ischemic heart failure were using statins at a higher rate (P <.001). In the Kaplan–Meier analysis of all patients, the mortality rate was 22.7% in statin users, while the mortality rate was significantly higher in those who did not use statins, 34.4% (P <.001). All-cause mortality was significantly higher in patients with ischemic heart failure not using statins than in patients using statins (P <.001) but not in non-ischemic heart failure (P =.07). Using statin was an independent predictor of all-cause mortality in all patients (hazard ratio: 0.661, 95% CI: 0.518-0.843, P =.001) and ischemic heart failure patients (hazard ratio: 0.618, 95% CI: 0.456-0.838, P =.002).


CONCLUSION
Since statin use reduces all-cause mortality in patients with ischemic heart failure, it may be recommended to continue statin therapy.