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Effect of rosuvasta...
Effect of rosuvastatin on repeat heart failure hospitalizations: The CORONA trial (controlled rosuvastatin multinational trial in heart failure)
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Rogers, J. K. (author)
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Jhund, P. S. (author)
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Perez, A. C. (author)
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Böhm, M. (author)
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Cleland, J. G. (author)
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Gullestad, L. (author)
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Kjekshus, J. (author)
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van Veldhuisen, D. J. (author)
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- Wikstrand, John, 1938 (author)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory
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Wedel, H. (author)
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McMurray, J. J. V. (author)
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Pocock, S. J. (author)
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(creator_code:org_t)
- Elsevier Inc. 2014
- 2014
- English.
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In: JACC: Heart Failure. - : Elsevier Inc.. - 2213-1787 .- 2213-1779. ; 2:3, s. 289-297
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Abstract
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- Objectives: This study sought to examine the effect of statin therapy hospitalizations for heart failure (HFH) in patients in the CORONA (Controlled Rosuvastatin Multinational Trial in Heart Failure) trial. Background: HFH is an important, frequently recurrent event. Conventional time-to-first event analyses do not take account repeat events. We used a number of statistical approaches to examine the effect of treatment on first and repeat HFH in the CORONA trial. Methods: In the CORONA trial, 5,011 patients ≥60 years of age with chronic New York Heart Association functional classes II to IV systolic heart failure resulting from ischemia were randomized to receive rosuvastatin or placebo. Poisson, Andersen-Gill, and negative binomial methods (NB) were used to analyze the effect of rosuvastatin on HFH, and the NB and a parametric joint frailty model (JF) were used to examine this effect while accounting for the competing risk of cardiovascular (CV) death. Rosuvastatin/placebo rate ratios were calculated, both unadjusted and adjusted. Results: A total of 1,291 patients had 1 or more HFH (750 of these had a single HFH only), and there were a total of 2,408 HFHs. The hazard ratio for the conventional time-to-first event analysis for HFH was 0.91 (95% confidence interval [CI]: 0.82 to 1.02, p = 0.105). In contrast, the NB on repeat hospitalizations gave an unadjusted RR (RR) for HFH of 0.86 (95% CI: 0.75 to 0.99, p = 0.030), adjusted 0.82 (95% CI: 0.72 to 0.92, p = 0.001), and after including CV death as the last event, adjusted RR of 0.85 (95% CI: 0.77 to 0.94, p = 0.001). The JF gave an adjusted RR of 0.82 (95% CI: 0.73 to 0.92, p = 0.001). Similar results were found in analyses of all CV hospitalizations and all-cause hospitalizations. Conclusions: When repeat events were included, rosuvastatin was shown to reduce the risk of HFH by approximately 15% to 20%, equating to approximately 76 fewer admissions per 1,000 patients treated over a median 33 months of follow-up. Including repeat events could increase the ability to detect treatment effects in heart failure trials. © 2014 American College of Cardiology Foundation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Heart failure
- Hospitalizations
- Statins
- amino terminal pro brain natriuretic peptide
- antithrombocytic agent
- beta adrenergic receptor blocking agent
- C reactive protein
- cholesterol
- creatinine
- dipeptidyl carboxypeptidase inhibitor
- low density lipoprotein
- placebo
- rosuvastatin
- triacylglycerol
- acute heart infarction
- adult
- aged
- article
- cardiovascular mortality
- cardiovascular risk
- cholesterol blood level
- controlled study
- creatinine blood level
- diastolic blood pressure
- drug efficacy
- female
- glomerulus filtration rate
- heart death
- heart ejection fraction
- heart rate
- hospital admission
- hospital readmission
- human
- lipoprotein blood level
- major clinical study
- male
- New York Heart Association class
- outcome assessment
- priority journal
- protein blood level
- randomized controlled trial (topic)
- retrospective study
- risk assessment
- systolic blood pressure
- systolic heart failure
- triacylglycerol blood level
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Rogers, J. K.
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Jhund, P. S.
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Perez, A. C.
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Böhm, M.
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Cleland, J. G.
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Gullestad, L.
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show more...
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Kjekshus, J.
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van Veldhuisen, ...
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Wikstrand, John, ...
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Wedel, H.
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McMurray, J. J. ...
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Pocock, S. J.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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JACC: Heart Fail ...
- By the university
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University of Gothenburg