Heart Failure

Could Statins Be The Next Breakthrough HFpEF Treatment?

A new JAMA study suggests that statins might have a massive impact on HFpEF care, even among patients who don’t have atherosclerosis.

Statins are one of the most-prescribed drug classes in the world, but there’s still little data on their heart failure benefits, especially for HFpEF patients. 

  • The two major RCTs evaluating statins as a heart failure treatment (CORONA and GISSI-HF) didn’t show significant benefits, although they mainly focused on HFrEF patients. 
  • Several observational studies suggest that statins do benefit HFpEF patients, specifically showing the medication’s mortality improvements, although the studies were smaller, non-US, and didn’t target patients without ASCVD.

This new study looked to further establish statins’ HFpEF impact. The researchers analyzed data from 7,970 VA patients who were diagnosed with HFpEF between 2002 to 2016, and didn’t have known ASCVD or a history of statin use at baseline.

Nearly half of the patients (47%) initiated statins after their HFpEF diagnosis, while the overall cohort included 5,314 deaths and 4,859 MACE events. 

Over a six-year follow-up and after propensity score overlap weighting, the statin-users had…

  • 22% lower risk of all-cause mortality
  • 21% lower risk of MACE
  • 31% lower risk of all-cause hospitalization
  • 28% lower risk of HF hospitalization

How do we explain these massive improvements? The authors believe that statins’ HFpEF benefits “go beyond its impact on atherosclerosis,” specifically citing statins’ ability to reduce inflammation and lower AFib risks (both of which are linked to HFpEF).

The Takeaway

These results suggest that a valuable HFpEF add-on treatment might be sitting in 47 million Americans’ drug cabinets, and they state a solid case for launching more research to assess statins’ HFpEF impact – including RCTs.

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