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Evidence Summary
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Key messages from scientific research that's ready to be acted on
Got It, Hide thisIn people with mild or no heart failure, statins reduce hospitalizations due to heart failure more than placebo, standard care, or lower-dose statins
Preiss D, Campbell RT, Murray HM, et al. The effect of statin therapy on heart failure events: a collaborative meta-analysis of unpublished data from major randomized trials. Eur Heart J. 2015;36:1536-46.
Review question
In people with mild or no heart failure, do statins reduce hospitalizations or death due to heart failure?
Background
People who have coronary heart disease often develop heart failure. Heart failure occurs when your heart can’t pump blood quickly enough to meet the needs of your body.
Statins are drugs that lower cholesterol levels in the blood and reduce cardiovascular events such as heart attacks or strokes. Statins may also prevent heart failure.
How the review was done
The researchers did a systematic review, searching for studies that were published in English up to January 2014.
They included 17 randomized controlled trials of statins to prevent new or repeated cardiovascular disease in their analysis. The trials included 132,568 adults (average age 63 years, 71% men). Studies were excluded if everyone in the study already had heart failure, had received an organ transplant, or was having dialysis for kidney failure.
The key features of the studies were:
- most people did not have heart failure; less than 3% had mild heart failure;
- statins used were atorvastatin, pravastatin, simvastatin, lovastatin, and rosuvastatin;
- statins were compared with placebo or standard care, or higher-dose statins were compared with lower-dose statins; and
- people were followed for an average 4.3 years.
What the researchers found
Compared with placebo, standard care, or lower-dose statins, statins:
- reduced the number of people hospitalized with nonfatal heart failure; and
- had similar rates of death due to heart failure.
Conclusion
In people with mild or no heart failure, statins reduce first hospitalizations due to heart failure more than placebo, standard care, or lower-dose statins.
Statins vs control (placebo, standard care, or lower-dose statins) in people with mild or no heart failure
| Outcomes* | Number of trials (people) | Rate of events with statins | Rate of events with control | Absolute effect of statins at an average 4.3 years |
| First hospitalization for nonfatal heart failure | 17 trials (132,568 people) | 2.0% | 2.3% | About 23 fewer people out of 10,000 had a first hospitalization for heart failure (from as few as 7 to as many as 36 out of 10,000) |
| Death due to heart failure | 14 trials (115,570 people) | 0.37% | 0.38% | No difference in effect† |
| First hospitalization for nonfatal heart failure or death due to heart failure | 14 trials (115,570 people) | 2.1% | 2.3% | About 19 fewer people out of 10,000 had a first hospitalization for heart failure or died due to heart failure (from as few as 2 to as many as 35 out of 10,000) |
Related Topics
Glossary
A fat-like substance with a soft, waxy texture.
Also known as coronary artery disease (CAD), is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart.
A harmless, inactive, and simulated treatment.
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.
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