Impact of statins on long-term prognosis in patients with ischemic chronic heart failure with renal dysfunction

Анотація

The aim of the study was to investigate the long-term effects of the inclusion in the basic therapy of statins in patients with ischemic chronic heart failure with renal dysfunction.Materials and methods. The study, after obtaining informed consent, involved 383 patients with ischemic CHF of II-IV functional class, median age – 59 [53; 66] years (men – 81.9 %). Patients were divided into two groups: group 1 – 140 patients (81.4 % of men) with ischemic CHF with reduced EF (HFrEF) and renal dysfunction, group 2 – 243 patients (82.3 % of men) with ischemic CHF with preserved EF (HFpEF) and renal dysfunction. As a hypolipidemic agent, patients received atorvastatin or rosuvastatin.Results. It was found that the inclusion of statins in the basic therapy for patients with HFrEF and renal dysfunction leads to a 51 % reduction in the risk of cumulative endpoint (relative risk (RR of 0.49; 95 % confidence interval (CI) of 0.26–0.91; P < 0.05) with preference for atorvastatin group versus rosuvastatin (RR 0.37; 95 % CI 0.21–0.69; P < 0.001). In patients with HFpEF and renal dysfunction using statins in the basic therapy, there was only a tendency to reduce the risk of cumulative endpoint (RR 0.62; 95 % CI 0.15–2.51; P > 0.05).Conclusions. In patients with ischemic CHF with reduced EF and renal dysfunction, the inclusion of statins (mainly atorvastatin) in the complex treatment is associated with a reduced risk of developing a cumulative endpoint, re-hospitalization for acute HF decompensation. Patients with ischemic CHF with preserved EF in the presence of renal dysfunction, atorvastatin should be given preference in the choice of hypolipidemic drug in order to reduce the risk of achieving cumulative endpoint.

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