Physicians' Academy for Cardiovascular Education

Statin therapy associated with reduced mortality in patients with HFpEF

Determinants of the survival benefit associated with statins in patients with acute heart failure

Literature - Park CS, Hwang IC, Park JJ et al. - ESC Heart Fail. 2021. doi: 10.1002/ehf2.13637.

Introduction and methods

Aim of the study

Inflammation and endothelial dysfunction are considered as potential targets for therapeutic interventions in HF [1,2]. Besides the well-known lipid-lowering effects, statins have anti-inflammatory properties and exert positive effects on endothelial function [3-6]. Studies have shown varying results on the effects of statins on mortality in patients with HF [7-9]. This study aimed to investigate the effect of statin therapy on 5-year mortality in patients with acute HF, stratified according to the etiology (ischemic vs. non-ischemic) and type of HF (HFrEF vs. HFpEF).

Study design

Patients hospitalized for acute HF were recruited between 2009 and 2016 from three university hospitals. A total of 3837 patients who underwent baseline echocardiography were included in the analysis. Of these patients, 1680 received statins and 2157 did not receive statins. 18.8% had ischemic HFrEF, 33.9% non-ischemic HFrEF, 14.9% had ischemic HFpEF and 33.4% had non-ischemic HFpEF.

Primary outcome

The primary outcome was 5-year all-cause mortality.

Main results


This study in patients with acute HF found that statin therapy was associated with reduced 5-year mortality in those with HFpEF and in those with an ischemic etiology of HF. The authors suggest that identification of HF subgroups based on clinical features and echocardiographic assessment may help to select HF patients who could potentially benefit from statin therapy.


Show references

Find this article online at ESC Heart Fail.

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