transparent gif


Ej inloggad.

Göteborgs universitets publikationer

Effect of rosuvastatin on repeat heart failure hospitalizations: The CORONA trial (controlled rosuvastatin multinational trial in heart failure)

Författare och institution:
J. K. Rogers (-); P. S. Jhund (-); A. C. Perez (-); M. Böhm (-); J. G. Cleland (-); L. Gullestad (-); J. Kjekshus (-); D. J. van Veldhuisen (-); John Wikstrand (Wallenberglaboratoriet); H. Wedel (-); J. J. V. McMurray (-); S. J. Pocock (-)
Publicerad i:
JACC: Heart Failure, 2 ( 3 ) s. 289-297
Artikel, refereegranskad vetenskaplig
Elsevier Inc.
Sammanfattning (abstract):
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.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
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
Postens nummer:
Posten skapad:
2015-03-31 14:40
Posten ändrad:
2015-03-31 14:45

Visa i Endnote-format

Göteborgs universitet • Tel. 031-786 0000
© Göteborgs universitet 2007