Effects of Statins After Transcatheter Aortic Valve Implantation in Key Patient Populations.
Aged
Aged, 80 and over
Aortic Valve Stenosis
/ diagnostic imaging
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ adverse effects
Male
Protective Factors
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Transcatheter Aortic Valve Replacement
/ adverse effects
Treatment Outcome
Journal
Journal of cardiovascular pharmacology
ISSN: 1533-4023
Titre abrégé: J Cardiovasc Pharmacol
Pays: United States
ID NLM: 7902492
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
received:
19
05
2021
accepted:
01
07
2021
pubmed:
30
7
2021
medline:
8
2
2022
entrez:
29
7
2021
Statut:
ppublish
Résumé
Statin therapy after transcatheter aortic valve replacement (TAVI) is associated with better short-term and long-term outcomes. It is of interest to identify specific patient populations that may profit from statin therapy. In this retrospective, observational analysis of 2862 patients with symptomatic aortic stenosis after successful transfemoral TAVI, survival during a three-year observation period was characterized by Kaplan-Meier analyses according to statin therapy. Hazard ratios and potential interactions for specific subgroups of patients were determined by Cox regression analyses. At hospital discharge 1761 patients were on low-intensity or moderate-intensity statins, 246 patients were on high-intensity statins, and 855 patients did not take statins. Statin therapy adherence during the first 3 months post-TAVI was 91%. Mortality rates were 18.5%, 12.9%, and 6.9% for patients with no statin, low-intensity or moderate-intensity statins, and high-intensity statins (P < 0.001). Any statin therapy proved to be effective in patients in different classes of age, risk, and manifest cardiovascular disease and was independent of background medication. Statins were of particular benefit in high-risk patients with coronary artery disease [hazard ratio (HR) = 0.57], ejection fraction <40% (HR = 0.64), or low-flow low-gradient aortic stenosis (HR = 0.58) and showed additional benefit even in patients taking renin-angiotensin system blockers (HR = 0.74). Statins also reduced mortality in patients with malignant disease (HR = 0.47). Our analysis confirmed the beneficial effect of statins on survival after TAVI and documented this phenomenon in key patient subsets. The protective effect of statins in our study is consistent with the cardioprotective mechanisms but must be explained by other, yet undetermined pleiotropic effects of statins.
Identifiants
pubmed: 34321397
doi: 10.1097/FJC.0000000000001114
pii: 00005344-202111000-00006
doi:
Substances chimiques
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e669-e674Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
M. Renker: speaker fees from St. Jude Medical/Abbott. C. Liebetrau: speaker fees from Abbott. Y.-H. Choi: proctor/speaker/scientific advisor fees from Getinge, Jotec/CryoLife, Cytosorbents. C. W. Hamm: advisory board Medtronic. W.-K. Kim: proctor/speaker fees from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, Meril Liefe Sciences, Shockwave Medical. The remaining authors report no conflicts of interest.
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