Statin withdrawal in stable heart failure patients results in no change in clinical status or quality of life

Abstract

Background: The current role of statins in heart failure with reduced ejection fraction (HFREF) is unclear. We therefore sought to investigate the effect of statin withdrawal in such patients, while taking optimal doses of proven heart failure medications. Methods: This was a prospective, randomised, single-blind, placebo-controlled, two-arm cross-over trial. Participants were randomised to either statin continuation (“statin on”) or unmatched placebo (“statin off”) and crossed over at 3 months. Study statin was the participants’ regular statin at their usual dose. Standard HF clinical status and quality of life (QoL) endpoints were evaluated. Groups were compared using Student's paired t-test. Results: The 13 study participants had a mean age of 64±11 years, 62% male, duration of HF was 7.7±5.7 years, and mean ejection fraction was 38.1±10.4%. Aetiology of HF was idiopathic (12) and ischaemic (1). Compared with taking statin, withdrawal of statin resulted in no significant changes in plasma brain natriuretic peptide (BNP, statin on: 130±49 vs statin off: 129±50ng/L, p=0.92) and no change in 6 minute walk distance (statin on: 455±52 vs statin off: 450±55m, p =0.80). No changes in QoL measures were observed, including Minnesota Living with HF score (statin on: 32±7 vs statin off: 31±9, p=0.41), Cardiac Depression Score (statin on: 77±6 vs statin off: 81±6, p=0.44) and SF-36 (statin on: 93±5 vs statin off: 94±5, p=0.25). Conclusions: Withdrawal of statins in stable HFREF patients receiving optimal background heart failure therapy did not alter HF clinical status including plasma BNP levels, submaximal exercise capacity or quality of life measures.