The effect of statin therapy on heart failure events: A collaborative meta-analysis of unpublished data from major randomized trials

David Preiss, Ross T. Campbell, Heather M. Murray, Ian Ford, Chris J. Packard, Naveed Sattar, Kazem Rahimi, Helen M. Colhoun, David D. Waters, John C. LaRosa, Pierre Amarenco, Terje R. Pedersen, Matti J. Tikkanen, Michael J. Koren, Neil R. Poulter, Peter S. Sever, Paul M. Ridker, Jean G. MacFadyen, Scott D. Solomon, Barry R. DavisLara M. Simpson, Haruo Nakamura, Kyoichi Mizuno, Rosa M. Marfisi, Roberto Marchioli, Gianni Tognoni, Vasilios G. Athyros, Kausik K. Ray, Antonio M. Gotto, Michael B. Clearfield, John R Downs, John J. McMurray

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Aims The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events. Methods and results We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- And secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring <30 days after within-trial myocardial infarction (MI) were excluded. We calculated risk ratios (RR) with fixed-effects meta analyses. In up to 17 trials with 132 538 participants conducted over 4.3 [weighted standard deviation (SD) 1.4] years, statin therapy reduced LDL-cholesterol by 0.97 mmol/L (weighted SD 0.38 mmol/L). Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84-0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95% CI 0.85-0.99) but not HF death (213/57 734 vs. 220/ 57 836;RR0.97,95%CI 0.80-1.17).The effect of statins on first non-fatal HF hospitalization was similar whether this was preceded by MI (RR 0.87, 95% CI 0.68-1.11) or not (RR 0.91, 95% CI 0.84-0.98). Conclusion In primary- And secondary-prevention trials, statins modestly reduced the risks of non-fatal HF hospitalization and a composite of nonfatal HF hospitalization and HF death with no demonstrable difference in risk reduction between those who suffered an MI or not.

Original languageEnglish (US)
Pages (from-to)1536-1546
Number of pages11
JournalEuropean Heart Journal
Volume36
Issue number24
DOIs
StatePublished - 2015

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Meta-Analysis
Heart Failure
Hospitalization
Therapeutics
Odds Ratio
Myocardial Infarction
Secondary Prevention
Randomized Controlled Trials
Risk Reduction Behavior

Keywords

  • Heart failure
  • Meta-analysis
  • Prevention
  • Randomized trial
  • Statin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Preiss, D., Campbell, R. T., Murray, H. M., Ford, I., Packard, C. J., Sattar, N., ... McMurray, J. J. (2015). The effect of statin therapy on heart failure events: A collaborative meta-analysis of unpublished data from major randomized trials. European Heart Journal, 36(24), 1536-1546. https://doi.org/10.1093/eurheartj/ehv072

The effect of statin therapy on heart failure events : A collaborative meta-analysis of unpublished data from major randomized trials. / Preiss, David; Campbell, Ross T.; Murray, Heather M.; Ford, Ian; Packard, Chris J.; Sattar, Naveed; Rahimi, Kazem; Colhoun, Helen M.; Waters, David D.; LaRosa, John C.; Amarenco, Pierre; Pedersen, Terje R.; Tikkanen, Matti J.; Koren, Michael J.; Poulter, Neil R.; Sever, Peter S.; Ridker, Paul M.; MacFadyen, Jean G.; Solomon, Scott D.; Davis, Barry R.; Simpson, Lara M.; Nakamura, Haruo; Mizuno, Kyoichi; Marfisi, Rosa M.; Marchioli, Roberto; Tognoni, Gianni; Athyros, Vasilios G.; Ray, Kausik K.; Gotto, Antonio M.; Clearfield, Michael B.; Downs, John R; McMurray, John J.

In: European Heart Journal, Vol. 36, No. 24, 2015, p. 1536-1546.

Research output: Contribution to journalArticle

Preiss, D, Campbell, RT, Murray, HM, Ford, I, Packard, CJ, Sattar, N, Rahimi, K, Colhoun, HM, Waters, DD, LaRosa, JC, Amarenco, P, Pedersen, TR, Tikkanen, MJ, Koren, MJ, Poulter, NR, Sever, PS, Ridker, PM, MacFadyen, JG, Solomon, SD, Davis, BR, Simpson, LM, Nakamura, H, Mizuno, K, Marfisi, RM, Marchioli, R, Tognoni, G, Athyros, VG, Ray, KK, Gotto, AM, Clearfield, MB, Downs, JR & McMurray, JJ 2015, 'The effect of statin therapy on heart failure events: A collaborative meta-analysis of unpublished data from major randomized trials', European Heart Journal, vol. 36, no. 24, pp. 1536-1546. https://doi.org/10.1093/eurheartj/ehv072
Preiss, David ; Campbell, Ross T. ; Murray, Heather M. ; Ford, Ian ; Packard, Chris J. ; Sattar, Naveed ; Rahimi, Kazem ; Colhoun, Helen M. ; Waters, David D. ; LaRosa, John C. ; Amarenco, Pierre ; Pedersen, Terje R. ; Tikkanen, Matti J. ; Koren, Michael J. ; Poulter, Neil R. ; Sever, Peter S. ; Ridker, Paul M. ; MacFadyen, Jean G. ; Solomon, Scott D. ; Davis, Barry R. ; Simpson, Lara M. ; Nakamura, Haruo ; Mizuno, Kyoichi ; Marfisi, Rosa M. ; Marchioli, Roberto ; Tognoni, Gianni ; Athyros, Vasilios G. ; Ray, Kausik K. ; Gotto, Antonio M. ; Clearfield, Michael B. ; Downs, John R ; McMurray, John J. / The effect of statin therapy on heart failure events : A collaborative meta-analysis of unpublished data from major randomized trials. In: European Heart Journal. 2015 ; Vol. 36, No. 24. pp. 1536-1546.
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abstract = "Aims The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events. Methods and results We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- And secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring <30 days after within-trial myocardial infarction (MI) were excluded. We calculated risk ratios (RR) with fixed-effects meta analyses. In up to 17 trials with 132 538 participants conducted over 4.3 [weighted standard deviation (SD) 1.4] years, statin therapy reduced LDL-cholesterol by 0.97 mmol/L (weighted SD 0.38 mmol/L). Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95{\%} confidence interval, CI 0.84-0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95{\%} CI 0.85-0.99) but not HF death (213/57 734 vs. 220/ 57 836;RR0.97,95{\%}CI 0.80-1.17).The effect of statins on first non-fatal HF hospitalization was similar whether this was preceded by MI (RR 0.87, 95{\%} CI 0.68-1.11) or not (RR 0.91, 95{\%} CI 0.84-0.98). Conclusion In primary- And secondary-prevention trials, statins modestly reduced the risks of non-fatal HF hospitalization and a composite of nonfatal HF hospitalization and HF death with no demonstrable difference in risk reduction between those who suffered an MI or not.",
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TY - JOUR

T1 - The effect of statin therapy on heart failure events

T2 - A collaborative meta-analysis of unpublished data from major randomized trials

AU - Preiss, David

AU - Campbell, Ross T.

AU - Murray, Heather M.

AU - Ford, Ian

AU - Packard, Chris J.

AU - Sattar, Naveed

AU - Rahimi, Kazem

AU - Colhoun, Helen M.

AU - Waters, David D.

AU - LaRosa, John C.

AU - Amarenco, Pierre

AU - Pedersen, Terje R.

AU - Tikkanen, Matti J.

AU - Koren, Michael J.

AU - Poulter, Neil R.

AU - Sever, Peter S.

AU - Ridker, Paul M.

AU - MacFadyen, Jean G.

AU - Solomon, Scott D.

AU - Davis, Barry R.

AU - Simpson, Lara M.

AU - Nakamura, Haruo

AU - Mizuno, Kyoichi

AU - Marfisi, Rosa M.

AU - Marchioli, Roberto

AU - Tognoni, Gianni

AU - Athyros, Vasilios G.

AU - Ray, Kausik K.

AU - Gotto, Antonio M.

AU - Clearfield, Michael B.

AU - Downs, John R

AU - McMurray, John J.

PY - 2015

Y1 - 2015

N2 - Aims The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events. Methods and results We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- And secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring <30 days after within-trial myocardial infarction (MI) were excluded. We calculated risk ratios (RR) with fixed-effects meta analyses. In up to 17 trials with 132 538 participants conducted over 4.3 [weighted standard deviation (SD) 1.4] years, statin therapy reduced LDL-cholesterol by 0.97 mmol/L (weighted SD 0.38 mmol/L). Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84-0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95% CI 0.85-0.99) but not HF death (213/57 734 vs. 220/ 57 836;RR0.97,95%CI 0.80-1.17).The effect of statins on first non-fatal HF hospitalization was similar whether this was preceded by MI (RR 0.87, 95% CI 0.68-1.11) or not (RR 0.91, 95% CI 0.84-0.98). Conclusion In primary- And secondary-prevention trials, statins modestly reduced the risks of non-fatal HF hospitalization and a composite of nonfatal HF hospitalization and HF death with no demonstrable difference in risk reduction between those who suffered an MI or not.

AB - Aims The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events. Methods and results We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- And secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring <30 days after within-trial myocardial infarction (MI) were excluded. We calculated risk ratios (RR) with fixed-effects meta analyses. In up to 17 trials with 132 538 participants conducted over 4.3 [weighted standard deviation (SD) 1.4] years, statin therapy reduced LDL-cholesterol by 0.97 mmol/L (weighted SD 0.38 mmol/L). Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84-0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95% CI 0.85-0.99) but not HF death (213/57 734 vs. 220/ 57 836;RR0.97,95%CI 0.80-1.17).The effect of statins on first non-fatal HF hospitalization was similar whether this was preceded by MI (RR 0.87, 95% CI 0.68-1.11) or not (RR 0.91, 95% CI 0.84-0.98). Conclusion In primary- And secondary-prevention trials, statins modestly reduced the risks of non-fatal HF hospitalization and a composite of nonfatal HF hospitalization and HF death with no demonstrable difference in risk reduction between those who suffered an MI or not.

KW - Heart failure

KW - Meta-analysis

KW - Prevention

KW - Randomized trial

KW - Statin

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