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Does Statin Benefits Patients with Heart Failure Undergoing Percutaneous Coronary Intervention? Findings from the Melbourne Interventional Group Registry

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Abstract

Purpose

The effectiveness of statins in improving clinical outcomes among patients with heart failure (HF) undergoing percutaneous coronary intervention (PCI) is unclear. We examined the association between use of statins and clinical outcomes in patients with HF included in the Melbourne Interventional Group registry.

Methods

Patients were followed from 30 days to 1 year post-PCI for a primary composite outcome of all-cause mortality and hospitalisation for cardiovascular (CV) causes. Secondary outcomes included major adverse cardiac events (MACE, a composite of all-cause mortality, myocardial infarction and target vessel revascularisation) and hospitalisation for CV causes. Outcomes were compared between statin-treated and non-statin-treated patients (at 30 days post-PCI) using propensity scores to balance for risk factors.

Results

Among 991 patients included in the inverse probability-weighted Cox model, statin use had no significant effect on the primary composite outcome [adjusted hazard ratio (aHR), 1.03; 95% confidence interval (CI), 0.68 to 1.56; p = 0.89], nor MACE (aHR, 0.99; 95% CI, 0.54 to 1.84; p = 0.99) or hospitalisation for CV causes (HR, 1.13; 95% CI, 0.74 to 1.72; p = 0.57).

Conclusions

Our results suggest that statin therapy may confer no significant benefits in patients with HF undergoing PCI. However, prospective randomised controlled trials are needed to provide more definitive answers.

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Acknowledgements

KLC receives a PhD scholarship from the Ministry of Education, Malaysia. This work was supported by a NHMRC Program Grant (1092642) awarded to CMR. CMR is supported by a Research Fellowship (1045862) from the National Health and Medical Research Council of Australia (NHMRC). IH is supported by a National Health and Medical Research Council Early Career Fellowship (1113314). SJD’s work is supported by NHMRC grants.

Funding

The Melbourne Interventional Group acknowledges funding from Abbott, Astra-Zeneca, Biotronik, Boston Scientific, Bristol-Myers Squibb, Cordis Johnson & Johnson, CSL, Medtronic, MSD, Pfizer, Sanofi-Aventis, Servier, Schering-Plough and The Medicines Company. The funding bodies had no role in the design and conduct of the study, the collection, management, analysis and interpretation of the data, or the preparation, review or approval of the manuscript.

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Authors and Affiliations

  1. Centre of Cardiovascular Research & Education (CCRE) in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Commercial Road, Melbourne, VIC, 3004, Australia

    Ken Lee Chin, Christopher M. Reid, Andrew Tonkin, Ingrid Hopper, Angela Brennan, Nick Andrianopoulos, Stephen J. Duffy & Danny Liew

  2. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

    Rory Wolfe

  3. School of Public Health, Curtin University, Perth, Australia

    Christopher M. Reid

  4. Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia

    Ingrid Hopper & Stephen J. Duffy

  5. Department of Cardiology, Austin Hospital, Melbourne, Australia

    David Clark

  6. Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia

    Andrew Ajani

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  1. Ken Lee Chin
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  2. Rory Wolfe
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  3. Christopher M. Reid
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  10. Andrew Ajani
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for the Melbourne Interventional Group (MIG)

Corresponding author

Correspondence to Danny Liew.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the Alfred Hospital Ethics Committee (107/16) and Monash University Human Research Ethics Committee (CF16/841 – 2016000420).

Informed Consent

The registry employed an ‘opt-out’ informed consent which requires patient to sign a declaration only if they refuse to contribute their relevant information, or do not want to be followed up beyond the coronary intervention.

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Chin, K.L., Wolfe, R., Reid, C.M. et al. Does Statin Benefits Patients with Heart Failure Undergoing Percutaneous Coronary Intervention? Findings from the Melbourne Interventional Group Registry. Cardiovasc Drugs Ther 32, 57–64 (2018). https://doi.org/10.1007/s10557-018-6769-y

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  • DOI: https://doi.org/10.1007/s10557-018-6769-y

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