Relation of Intensity of Statin Therapy and Outcomes After Transcatheter Aortic Valve Replacement

Chetan P. Huded, Lillian R. Benck, Neil J Stone, Ranya Nabil Sweis, Mark J Ricciardi, S Chris Malaisrie, Charles J Davidson, James D Flaherty*

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Statin therapy is associated with improved survival in patients at high risk for cardiovascular mortality, but the impact of statin therapy in patients treated with transcatheter aortic valve replacement (TAVR) is unknown. We reviewed 294 consecutive cases of TAVR performed at a single tertiary care medical center. We defined high-intensity statin therapy as atorvastatin 40 to 80 mg/day or rosuvastatin 20 to 40 mg/day. Study outcomes included post-TAVR adverse events, 30-day mortality, and overall survival. At the time of TAVR, 14% (n = 41) were on high-intensity statin therapy, 59% (n = 173) were on low- or moderate-intensity statin therapy, and 27% (n = 80) were not on statin therapy. There was no association between statin therapy and the rate of post-TAVR stroke, myocardial infarction, acute kidney injury, in-hospital mortality, or 30-day mortality. At 2 years, 83% of patients in the high-intensity statin group were alive, 70% in the low/moderate-intensity statin group were alive, and 57% in the no statin group were alive (log-rank p = 0.016). In a risk-adjusted model, high-intensity statin therapy was associated with a 64% reduction in all-cause mortality (hazard ratio 0.36, 95% CI 0.14 to 0.90, p = 0.029) compared with no statin therapy. In conclusion, statin therapy is associated with improved overall survival after TAVR in a dose-dependent manner.

Original languageEnglish (US)
Pages (from-to)1832-1838
Number of pages7
JournalAmerican Journal of Cardiology
Volume119
Issue number11
DOIs
StatePublished - Jun 1 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Therapeutics
Mortality
Transcatheter Aortic Valve Replacement
Survival
Hospital Mortality
Acute Kidney Injury
Tertiary Care Centers

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{f4b1e7453f3845afbda243d58df09446,
title = "Relation of Intensity of Statin Therapy and Outcomes After Transcatheter Aortic Valve Replacement",
abstract = "Statin therapy is associated with improved survival in patients at high risk for cardiovascular mortality, but the impact of statin therapy in patients treated with transcatheter aortic valve replacement (TAVR) is unknown. We reviewed 294 consecutive cases of TAVR performed at a single tertiary care medical center. We defined high-intensity statin therapy as atorvastatin 40 to 80 mg/day or rosuvastatin 20 to 40 mg/day. Study outcomes included post-TAVR adverse events, 30-day mortality, and overall survival. At the time of TAVR, 14{\%} (n = 41) were on high-intensity statin therapy, 59{\%} (n = 173) were on low- or moderate-intensity statin therapy, and 27{\%} (n = 80) were not on statin therapy. There was no association between statin therapy and the rate of post-TAVR stroke, myocardial infarction, acute kidney injury, in-hospital mortality, or 30-day mortality. At 2 years, 83{\%} of patients in the high-intensity statin group were alive, 70{\%} in the low/moderate-intensity statin group were alive, and 57{\%} in the no statin group were alive (log-rank p = 0.016). In a risk-adjusted model, high-intensity statin therapy was associated with a 64{\%} reduction in all-cause mortality (hazard ratio 0.36, 95{\%} CI 0.14 to 0.90, p = 0.029) compared with no statin therapy. In conclusion, statin therapy is associated with improved overall survival after TAVR in a dose-dependent manner.",
author = "Huded, {Chetan P.} and Benck, {Lillian R.} and Stone, {Neil J} and Sweis, {Ranya Nabil} and Ricciardi, {Mark J} and Malaisrie, {S Chris} and Davidson, {Charles J} and Flaherty, {James D}",
year = "2017",
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language = "English (US)",
volume = "119",
pages = "1832--1838",
journal = "American Journal of Cardiology",
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T1 - Relation of Intensity of Statin Therapy and Outcomes After Transcatheter Aortic Valve Replacement

AU - Huded, Chetan P.

AU - Benck, Lillian R.

AU - Stone, Neil J

AU - Sweis, Ranya Nabil

AU - Ricciardi, Mark J

AU - Malaisrie, S Chris

AU - Davidson, Charles J

AU - Flaherty, James D

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Statin therapy is associated with improved survival in patients at high risk for cardiovascular mortality, but the impact of statin therapy in patients treated with transcatheter aortic valve replacement (TAVR) is unknown. We reviewed 294 consecutive cases of TAVR performed at a single tertiary care medical center. We defined high-intensity statin therapy as atorvastatin 40 to 80 mg/day or rosuvastatin 20 to 40 mg/day. Study outcomes included post-TAVR adverse events, 30-day mortality, and overall survival. At the time of TAVR, 14% (n = 41) were on high-intensity statin therapy, 59% (n = 173) were on low- or moderate-intensity statin therapy, and 27% (n = 80) were not on statin therapy. There was no association between statin therapy and the rate of post-TAVR stroke, myocardial infarction, acute kidney injury, in-hospital mortality, or 30-day mortality. At 2 years, 83% of patients in the high-intensity statin group were alive, 70% in the low/moderate-intensity statin group were alive, and 57% in the no statin group were alive (log-rank p = 0.016). In a risk-adjusted model, high-intensity statin therapy was associated with a 64% reduction in all-cause mortality (hazard ratio 0.36, 95% CI 0.14 to 0.90, p = 0.029) compared with no statin therapy. In conclusion, statin therapy is associated with improved overall survival after TAVR in a dose-dependent manner.

AB - Statin therapy is associated with improved survival in patients at high risk for cardiovascular mortality, but the impact of statin therapy in patients treated with transcatheter aortic valve replacement (TAVR) is unknown. We reviewed 294 consecutive cases of TAVR performed at a single tertiary care medical center. We defined high-intensity statin therapy as atorvastatin 40 to 80 mg/day or rosuvastatin 20 to 40 mg/day. Study outcomes included post-TAVR adverse events, 30-day mortality, and overall survival. At the time of TAVR, 14% (n = 41) were on high-intensity statin therapy, 59% (n = 173) were on low- or moderate-intensity statin therapy, and 27% (n = 80) were not on statin therapy. There was no association between statin therapy and the rate of post-TAVR stroke, myocardial infarction, acute kidney injury, in-hospital mortality, or 30-day mortality. At 2 years, 83% of patients in the high-intensity statin group were alive, 70% in the low/moderate-intensity statin group were alive, and 57% in the no statin group were alive (log-rank p = 0.016). In a risk-adjusted model, high-intensity statin therapy was associated with a 64% reduction in all-cause mortality (hazard ratio 0.36, 95% CI 0.14 to 0.90, p = 0.029) compared with no statin therapy. In conclusion, statin therapy is associated with improved overall survival after TAVR in a dose-dependent manner.

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JF - American Journal of Cardiology

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