Statins in heart failure: retrospective cohort study using routine primary care data

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Statins in heart failure: retrospective cohort study using routine primary care data. / Ryan, Ronan; McManus, Richard; Mant, J; Macleod, J; Hobbs, Frederick.

In: Annals of Medicine, Vol. 41, No. 7, 2009, p. 490-6.

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@article{d46196a4f36c4cce88b28666f2ef051a,
title = "Statins in heart failure: retrospective cohort study using routine primary care data",
abstract = "Introduction. Studies suggest no benefit from statins in heart failure (HF), but many individuals in primary care are prescribed statins before HF diagnosis. This study aimed to assess the effect of a statin prescription prior to HF diagnosis on survival in an incident HF population. Material and methods. Cases of HF diagnosed between 1995 and 2004 in 315 UK primary care practices were identified from electronic case records and followed up for 2 years from diagnosis. Statin prescribing before and after HF diagnosis was assessed, and Cox regression was used to determine the contribution of statin treatment to survival. Results. A total of 10,914 cases met the inclusion criteria of whom 20% (2185/10,914) were treated with a statin prior to HF diagnosis. Two per cent (191/8729) had an initial statin prescription following diagnosis. Cases prescribed a statin before heart failure diagnosis had a lower risk of death in the subsequent 2 years (hazard ratio 0.52; 95% confidence interval 0.39-0.68), after adjustment for confounders. Discussion. Most people with heart failure prescribed statins in primary care commenced them prior to diagnosis and appeared to gain benefit, presumably through the effect of statins on cardiovascular co-morbidities. Primary care physicians should not discontinue prior statin treatment at the time of heart failure diagnosis.",
keywords = "hydroxymethylglutaryl-CoA reductase inhibitors, survival analysis, bleeding, thromboembolism, Cohort studies, cerebrovascular thrombosis, Coumadin, warfarin, heart failure, Atrial fibrillation, anticoagulation",
author = "Ronan Ryan and Richard McManus and J Mant and J Macleod and Frederick Hobbs",
year = "2009",
doi = "10.1080/07853890903022819",
language = "English",
volume = "41",
pages = "490--6",
journal = "Annals of Medicine",
issn = "0785-3890",
publisher = "Taylor & Francis",
number = "7",

}

RIS

TY - JOUR

T1 - Statins in heart failure: retrospective cohort study using routine primary care data

AU - Ryan, Ronan

AU - McManus, Richard

AU - Mant, J

AU - Macleod, J

AU - Hobbs, Frederick

PY - 2009

Y1 - 2009

N2 - Introduction. Studies suggest no benefit from statins in heart failure (HF), but many individuals in primary care are prescribed statins before HF diagnosis. This study aimed to assess the effect of a statin prescription prior to HF diagnosis on survival in an incident HF population. Material and methods. Cases of HF diagnosed between 1995 and 2004 in 315 UK primary care practices were identified from electronic case records and followed up for 2 years from diagnosis. Statin prescribing before and after HF diagnosis was assessed, and Cox regression was used to determine the contribution of statin treatment to survival. Results. A total of 10,914 cases met the inclusion criteria of whom 20% (2185/10,914) were treated with a statin prior to HF diagnosis. Two per cent (191/8729) had an initial statin prescription following diagnosis. Cases prescribed a statin before heart failure diagnosis had a lower risk of death in the subsequent 2 years (hazard ratio 0.52; 95% confidence interval 0.39-0.68), after adjustment for confounders. Discussion. Most people with heart failure prescribed statins in primary care commenced them prior to diagnosis and appeared to gain benefit, presumably through the effect of statins on cardiovascular co-morbidities. Primary care physicians should not discontinue prior statin treatment at the time of heart failure diagnosis.

AB - Introduction. Studies suggest no benefit from statins in heart failure (HF), but many individuals in primary care are prescribed statins before HF diagnosis. This study aimed to assess the effect of a statin prescription prior to HF diagnosis on survival in an incident HF population. Material and methods. Cases of HF diagnosed between 1995 and 2004 in 315 UK primary care practices were identified from electronic case records and followed up for 2 years from diagnosis. Statin prescribing before and after HF diagnosis was assessed, and Cox regression was used to determine the contribution of statin treatment to survival. Results. A total of 10,914 cases met the inclusion criteria of whom 20% (2185/10,914) were treated with a statin prior to HF diagnosis. Two per cent (191/8729) had an initial statin prescription following diagnosis. Cases prescribed a statin before heart failure diagnosis had a lower risk of death in the subsequent 2 years (hazard ratio 0.52; 95% confidence interval 0.39-0.68), after adjustment for confounders. Discussion. Most people with heart failure prescribed statins in primary care commenced them prior to diagnosis and appeared to gain benefit, presumably through the effect of statins on cardiovascular co-morbidities. Primary care physicians should not discontinue prior statin treatment at the time of heart failure diagnosis.

KW - hydroxymethylglutaryl-CoA reductase inhibitors

KW - survival analysis

KW - bleeding

KW - thromboembolism

KW - Cohort studies

KW - cerebrovascular thrombosis

KW - Coumadin

KW - warfarin

KW - heart failure

KW - Atrial fibrillation

KW - anticoagulation

U2 - 10.1080/07853890903022819

DO - 10.1080/07853890903022819

M3 - Article

C2 - 19521887

VL - 41

SP - 490

EP - 496

JO - Annals of Medicine

JF - Annals of Medicine

SN - 0785-3890

IS - 7

ER -