Prognostic Impact of Statin Use in Patients With Heart Failure and Preserved Ejection Fraction : A Report From the CHART-2 Study

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  • Nochioka Kotaro
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Sakata Yasuhiko
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Miyata Satoshi
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Miura Masanobu
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Takada Tsuyoshi
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Tadaki Soichiro
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Ushigome Ryoichi
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Yamauchi Takeshi
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Takahashi Jun
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • Shimokawa Hiroaki
    Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
  • on behalf of the CHART-2 Investigators’

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タイトル別名
  • Prognostic Impact of Statin Use in Patients With Heart Failure and Preserved Ejection Fraction
  • – A Report From the CHART-2 Study –

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Background:The effectiveness of statins remains to be examined in patients with heart failure (HF) with preserved ejection fraction (EF).Methods and Results:Among 4,544 consecutive HF patients registered in the Chronic Heart Failure Registry and Analysis in the Tohoku district-2 (CHART-2) between 2006 and 2010, 3,124 had EF ≥50% (HFpEF; mean age 69 years; male 65%) and 1,420 had EF <50% (HF with reduced EF (HFrEF); mean age 67 years; male 75%). The median follow-up was 3.4 years. The 3-year mortality in HFpEF patients was lower in patients receiving statins [8.7% vs. 14.5%, adjusted hazard ratio (HR) 0.74; 95% confidence interval (CI), 0.58–0.94; P<0.001], which was confirmed in the propensity score-matched cohort (HR, 0.72; 95% CI, 0.49–0.99; P=0.044). The inverse probability of treatment weighted further confirmed that statin use was associated with reduced incidence of all-cause death (HR, 0.71; 95% CI, 0.62–0.82, P<0.001) and noncardiovascular death (HR, 0.53; 95% CI, 0.43–0.66, P<0.001), specifically reduction of sudden death (HR, 0.59; 95% CI, 0.36–0.98, P=0.041) and infection death (HR, 0.53; 95% CI, 0.35–0.77, P=0.001) in HFpEF. In the HFrEF cohort, statin use was not associated with mortality (HR, 0.87; 95% CI, 0.73–1.04, P=0.12), suggesting a lack of statin benefit in HFrEF patients.Conclusions:These results suggest that statin use is associated with improved mortality rates in HFpEF patients, mainly attributable to reductions in sudden death and noncardiovascular death. (Circ J 2015; 79: 574–582)

収録刊行物

  • Circulation Journal

    Circulation Journal 79 (3), 574-582, 2015

    一般社団法人 日本循環器学会

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