Impact of aspirin and statins on long-term survival in patients hospitalized with acute myocardial infarction complicated by heart failure: an analysis of 1706 patients
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Impact of aspirin and statins on long-term survival in patients hospitalized with acute myocardial infarction complicated by heart failure : an analysis of 1706 patients. / Lewinter, Christian; Bland, John M; Crouch, Simon; Cleland, John G F; Doherty, Patrick; LeWinter, Martin M; Køber, Lars; Hall, Alistair S; Gale, Christopher P.
In: European Journal of Heart Failure, Vol. 16, No. 1, 01.2014, p. 95-102.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of aspirin and statins on long-term survival in patients hospitalized with acute myocardial infarction complicated by heart failure
T2 - an analysis of 1706 patients
AU - Lewinter, Christian
AU - Bland, John M
AU - Crouch, Simon
AU - Cleland, John G F
AU - Doherty, Patrick
AU - LeWinter, Martin M
AU - Køber, Lars
AU - Hall, Alistair S
AU - Gale, Christopher P
N1 - © 2013 The Authors. European Journal of Heart Failure © 2013 European Society of Cardiology.
PY - 2014/1
Y1 - 2014/1
N2 - AIMS: Aspirin and statins are established therapies for acute myocardial infarction (MI), but their benefits in patients with chronic heart failure (HF) remain elusive. We investigated the impact of aspirin and statins on long-term survival in patients hospitalized with acute MI complicated by HF.METHODS AND RESULTS: Of 4251 patients in the Evaluation of Methods and Management of Acute Coronary Events (EMMACE)-1 and -2 observational studies, 1706 patients had HF. A propensity score-matching method estimated the average treatment effects (ATEs) of aspirin and statins on survival over 90 months. ATEs were calculated as relative risk differences in all-cause mortality comparing patients receiving aspirin and statins with controls, respectively. Moreover, combined aspirin and statins vs. none (ATE I), aspirin or statins vs. none (ATE II), and aspirin and statins vs. aspirin or statins (ATE III) were assessed. The median survival times of the ATE I, ATE II and ATE III were 25, 50, and 85 months, respectively. Regarding aspirin, the ATE was significantly improved at 6, 12, and 90 months [ATE 6 months: 10%, 95% confidence interval (CI) 3-18%], where the ATE of statins favoured survival at 1-24 months (ATE 1 month: 5%, 95% CI 0.3-10%). Mortality was lower at 1, 6, and 24 months in those who received aspirin and statins (ATE I). When the combination was compared with either treatment alone, an effect persisted between 6 and 90 months (ATE III).CONCLUSION: In patients with acute MI complicated by HF, prescription of aspirin and statins either alone or together was associated with better long-term survival.
AB - AIMS: Aspirin and statins are established therapies for acute myocardial infarction (MI), but their benefits in patients with chronic heart failure (HF) remain elusive. We investigated the impact of aspirin and statins on long-term survival in patients hospitalized with acute MI complicated by HF.METHODS AND RESULTS: Of 4251 patients in the Evaluation of Methods and Management of Acute Coronary Events (EMMACE)-1 and -2 observational studies, 1706 patients had HF. A propensity score-matching method estimated the average treatment effects (ATEs) of aspirin and statins on survival over 90 months. ATEs were calculated as relative risk differences in all-cause mortality comparing patients receiving aspirin and statins with controls, respectively. Moreover, combined aspirin and statins vs. none (ATE I), aspirin or statins vs. none (ATE II), and aspirin and statins vs. aspirin or statins (ATE III) were assessed. The median survival times of the ATE I, ATE II and ATE III were 25, 50, and 85 months, respectively. Regarding aspirin, the ATE was significantly improved at 6, 12, and 90 months [ATE 6 months: 10%, 95% confidence interval (CI) 3-18%], where the ATE of statins favoured survival at 1-24 months (ATE 1 month: 5%, 95% CI 0.3-10%). Mortality was lower at 1, 6, and 24 months in those who received aspirin and statins (ATE I). When the combination was compared with either treatment alone, an effect persisted between 6 and 90 months (ATE III).CONCLUSION: In patients with acute MI complicated by HF, prescription of aspirin and statins either alone or together was associated with better long-term survival.
KW - Aged
KW - Aged, 80 and over
KW - Aspirin
KW - Cyclooxygenase Inhibitors
KW - Drug Therapy, Combination
KW - Follow-Up Studies
KW - Great Britain
KW - Heart Failure
KW - Humans
KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors
KW - Inpatients
KW - Male
KW - Myocardial Infarction
KW - Prognosis
KW - Prospective Studies
KW - Survival Rate
KW - Time Factors
U2 - 10.1002/ejhf.40
DO - 10.1002/ejhf.40
M3 - Journal article
C2 - 24453098
VL - 16
SP - 95
EP - 102
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1567-4215
IS - 1
ER -
ID: 138139588