By David Ramsey, EAS 2015

Data presented at the 83rd Annual Congress of the European Atherosclerosis Society (EAS) March 21-25, Glasgow, Scotland, UK Glasgow revealed that the use of statins reduces hospital admissions for heart failure by a healthy 10%.

Lead author, Dr David Preiss, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK said: “Heart failure is disabling, expensive to treat, especially in more advanced stages, and patients have a poor outcome. While it has been assumed that statins reduce the development of heart failure simply because they reduce heart attacks, to our surprise this had not been definitively shown before. The results of this meta-analysis clearly show a modest, but significant benefit, reducing hospital admission for heart failure by 10 percent which is clinically important.”

Whilst logic dictates that statins should reduce hospital admissions simply because they reduce the risk of heart attacks with or without pre-existing heart disease, none of the previous placebo-controlled statin trials had conclusively demonstrated a reduction in heart failure risk.

Researchers at the University of Glasgow together with colleagues from Europe, USA and Asia, evaluated unpublished data from 132,568 subjects included in 17 statin trials, followed for an average of 4.3 years. The trials were conducted in patients with and without coronary disease, and each trial enrolled more than 1000 subjects followed-up for more than one year. Three end points were of interest: a first non-fatal hospital admission for heart failure, heart failure death and a composite of both endpoints.

The analysis showed:

• A 10 percent reduction in first heart failure hospital admission (relative risk 0.90, 95 percent confidence interval 0.84 to 0.97). Overall, 200 patients with heart disease would need to be treated over 5 years to prevent one hospital admission.
• An 8 percent reduction in the composite end point, which was driven by the effect of statin treatment on heart failure hospital admission (relative risk 0.92, 95 percent confidence interval 0.85 to 0.99).
• There were insufficient data to show that statin treatment could reduce heart failure death (relative risk 0.97, 95 percent confidence interval 0.80 to 1.17).

“The 10 percent reduction in hospital admission for heart failure could easily be an underestimate of the true effect, given that the trials were only 4 years duration on average, and the data only related to first heart failure events. With emerging data showing accrual of benefit from statins in the long-term, the 10 percent reduction is just the beginning of benefit from statin therapy. Additionally, if all heart failure admissions were taken into account, we suspect that the benefit would be much larger,” said Dr David Preiss.