Sumner Andrew D, Boehmer John P, Saxon Leslie A, Carson Peter, Feldman Arthur M, Galle Elizabeth, Bristow Michael R
Division of Cardiology, Lehigh Valley Health Network, Allentown, PA 18103, USA.
Congest Heart Fail. 2009 Jul-Aug;15(4):159-64. doi: 10.1111/j.1751-7133.2009.00057.x.
It is unknown whether statin use improves survival in patients with advanced chronic heart failure (HF) receiving cardiac resynchronization therapy (CRT). The authors retrospectively assessed the effect of statin use on survival in patients with advanced chronic HF receiving CRT alone (CRT-P) or CRT with implantable cardioverter-defibrillator therapy (CRT-D) in 1520 patients with advanced chronic HF from the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) trial database. Six hundred three patients (40%) were taking statins at baseline. All-cause mortality was 18% in the statin group and 22% in the no statin group (hazard ratio [HR] 0.85; confidence interval (CI), 0.67-1.07; P=.15). In a multivariable analysis controlling for significant baseline characteristics and use of CRT-P/CRT-D, statin use was associated with a 23% relative risk reduction in mortality (HR, 0.77; CI, 0.61-0.97; P=.03). Statin use is associated with improved survival in patients with advanced chronic HF receiving CRT. No survival benefit was seen in patients receiving statins and optimal pharmacologic therapy without CRT.
在接受心脏再同步治疗（CRT）的晚期慢性心力衰竭（HF）患者中，使用他汀类药物是否能提高生存率尚不清楚。作者回顾性评估了他汀类药物的使用对1520例来自心力衰竭的药物治疗、起搏和除颤比较（COMPANION）试验数据库的晚期慢性HF患者的生存率的影响，这些患者单独接受CRT（CRT-P）或接受CRT联合植入式心律转复除颤器治疗（CRT-D）。603例患者（40%）在基线时服用他汀类药物。他汀类药物组的全因死亡率为18%，未服用他汀类药物组为22%（风险比[HR]0.85；置信区间[CI]，0.67 - 1.07；P = 0.15）。在对显著的基线特征和CRT-P/CRT-D的使用进行控制的多变量分析中，使用他汀类药物与死亡率相对风险降低23%相关（HR，0.77；CI，0.61 - 0.97；P = 0.03）。在接受CRT的晚期慢性HF患者中，使用他汀类药物与生存率提高相关。在接受他汀类药物和最佳药物治疗但未接受CRT的患者中未观察到生存获益。
