PDF(Pubmed)
Abstract：
UNASSIGNED: Statin therapy is well-established for treating hyperlipidemia and ischemic heart disease (IHD), but its role in Acute Decompensated Heart Failure (ADHF) remains less clear. Despite varying clinical guidelines, the actual utilization and impact of statin therapy initiation in patients with ADHF with an independent indication for statin therapy have not been thoroughly explored.
UNASSIGNED: We conducted a retrospective observational study on 5978 patients admitted with ADHF between January 1st, 2007, and December 31st, 2017. Patients were grouped based on their statin therapy status at admission and discharge. We performed multivariable analyses to identify independent predictors of short-term, intermediate-term, and long-term mortality. A sensitivity analysis was also conducted on patients with an independent indication for statin therapy but who were not on statins at admission.
UNASSIGNED: Of the total patient cohort, 73.9% had an indication for statin therapy. However, only 38.2% were treated with statins at admission, and 56.1% were discharged with a statin prescription. Patients discharged with statins were younger, predominantly male, and had a higher prevalence of IHD and other comorbidities. Statin therapy at discharge was an independent negative predictor of 5-year all-cause mortality (hazard ratio 0.80, 95% confidence interval 0.76-0.85). The sensitivity analysis confirmed these findings, demonstrating higher mortality rates in patients not initiated on statins during admission.
UNASSIGNED: The study highlights significant underutilization of statin therapy among patients admitted with ADHF, even when there\'s an independent indication for such treatment. Importantly, initiation of statin therapy during hospital admission was independently associated with improved long-term survival.
UNASSIGNED: We conducted a retrospective observational study on 5978 patients admitted with ADHF between January 1st, 2007, and December 31st, 2017. Patients were grouped based on their statin therapy status at admission and discharge. We performed multivariable analyses to identify independent predictors of short-term, intermediate-term, and long-term mortality. A sensitivity analysis was also conducted on patients with an independent indication for statin therapy but who were not on statins at admission.
UNASSIGNED: Of the total patient cohort, 73.9% had an indication for statin therapy. However, only 38.2% were treated with statins at admission, and 56.1% were discharged with a statin prescription. Patients discharged with statins were younger, predominantly male, and had a higher prevalence of IHD and other comorbidities. Statin therapy at discharge was an independent negative predictor of 5-year all-cause mortality (hazard ratio 0.80, 95% confidence interval 0.76-0.85). The sensitivity analysis confirmed these findings, demonstrating higher mortality rates in patients not initiated on statins during admission.
UNASSIGNED: The study highlights significant underutilization of statin therapy among patients admitted with ADHF, even when there\'s an independent indication for such treatment. Importantly, initiation of statin therapy during hospital admission was independently associated with improved long-term survival.
摘要：
■他汀类药物治疗高脂血症和缺血性心脏病（IHD）是公认的，但其在急性失代偿性心力衰竭（ADHF）中的作用尚不清楚。尽管有不同的临床指南，在有独立的他汀类药物治疗指征的ADHF患者中,他汀类药物治疗的实际使用情况和影响尚未被彻底研究.
■我们在1月1日期间对5978例ADHF患者进行了回顾性观察研究，2007年12月31日,2017.根据入院和出院时的他汀类药物治疗状态对患者进行分组。我们进行了多变量分析，以确定短期，中期,和长期死亡率。还对有他汀类药物治疗独立指征但入院时未使用他汀类药物的患者进行了敏感性分析。
■在总患者队列中，73.9%有他汀类药物治疗指征。然而,入院时只有38.2%接受他汀类药物治疗,56.1%的患者服用他汀类药物后出院。他汀类药物出院的患者更年轻，主要是男性,IHD和其他合并症的患病率较高。出院时他汀类药物治疗是5年全因死亡率的独立阴性预测因子（风险比0.80，95％置信区间0.76-0.85）。敏感性分析证实了这些发现，在入院期间未开始使用他汀类药物的患者中，显示出更高的死亡率。
■该研究强调了ADHF患者对他汀类药物治疗的严重利用不足，即使有这种治疗的独立指征。重要的是,住院期间开始他汀类药物治疗与长期生存率的改善独立相关.
■我们在1月1日期间对5978例ADHF患者进行了回顾性观察研究，2007年12月31日,2017.根据入院和出院时的他汀类药物治疗状态对患者进行分组。我们进行了多变量分析，以确定短期，中期,和长期死亡率。还对有他汀类药物治疗独立指征但入院时未使用他汀类药物的患者进行了敏感性分析。
■在总患者队列中，73.9%有他汀类药物治疗指征。然而,入院时只有38.2%接受他汀类药物治疗,56.1%的患者服用他汀类药物后出院。他汀类药物出院的患者更年轻，主要是男性,IHD和其他合并症的患病率较高。出院时他汀类药物治疗是5年全因死亡率的独立阴性预测因子（风险比0.80，95％置信区间0.76-0.85）。敏感性分析证实了这些发现，在入院期间未开始使用他汀类药物的患者中，显示出更高的死亡率。
■该研究强调了ADHF患者对他汀类药物治疗的严重利用不足，即使有这种治疗的独立指征。重要的是,住院期间开始他汀类药物治疗与长期生存率的改善独立相关.
