Cited by 172Lipoproteins and Cardiovascular HealthHeart Failure Treatment and ManagementHeart rate and cardiovascular health

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Effect of High-Dose Atorvastatin on Hospitalizations for Heart Failure: Subgroup Analysis of the Treating to New Targets (TNT) Study

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Khush, Kiran K., Waters, David D., Bittner, Vera, Deedwania, Prakash C., Kastelein, John J.P., Lewis, Sandra J., Wenger, Nanette K.·2007·Circulation

DOI 10.1161/circulationaha.106.625574

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Abstract

Background— Statins reduce the rate of major cardiovascular events in high-risk patients, but their potential benefit as treatment for heart failure (HF) is less clear. Methods and Results— Patients (n=10 001) with stable coronary disease were randomized to treatment with atorvastatin 80 or 10 mg/d and followed up for a median of 4.9 years. A history of HF was present in 7.8% of patients. A known ejection fraction <30% and advanced HF were exclusion criteria for the study. A predefined secondary end point of the study was hospitalization for HF. The incidence of hospitalization for HF was 2.4% in the 80-mg arm and 3.3% in the 10-mg arm (hazard ratio, 0.74; 95% confidence interval, 0.59 to 0.94; P =0.0116). The treatment effect of the higher dose was more marked in patients with a history of HF: 17.3% versus 10.6% in the 10- and 80-mg arms, respectively (hazard ratio, 0.59; 95% confidence interval, 0.4 to 0.88; P =0.009). Among patients without a history of HF, the rates of hospitalization for HF were much lower: 1.8% in the 80-mg group and 2.0% in the 10-mg group (hazard ratio, 0.87; 95% confidence interval, 0.64 to 1.16; P =0.34). Only one third of patients hospitalized for HF had evidence of preceding angina or myocardial infarction during the study period. Blood pressure was almost identical during follow-up in the treatment groups. Conclusions— Compared with a lower dose, intensive treatment with atorvastatin in patients with stable coronary disease significantly reduces hospitalizations for HF. In a post hoc analysis, this benefit was observed only in patients with a history of HF. The mechanism accounting for this benefit is unlikely to be due primarily to a reduction in interim coronary events or differences in blood pressure.

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10.1161/circ.97.12.1129 · DOI
10.1161/circ.104.5.576 · DOI
10.1161/circ.77.4.3280156 · DOI
10.1161/circ.99.16.2113 · DOI
10.1161/circ.100.3.230 · DOI

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Authors: Khush, K. K., Waters, D. D., Bittner, V., Deedwania, P. C., Kastelein, J. J. P., Lewis, S. J., & Wenger, N. K.
Affiliations: Emory University (US)
ORCID: Khush, Kiran K.
Waters, David D.
Bittner, Vera
Deedwania, Prakash C.
Kastelein, John J.P.
Lewis, Sandra J.
Wenger, Nanette K.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2007-02-06
Volume: 115
Issue: 5
Pages: 576-583
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.106.625574
OpenAlex: W2103918731
Cited by: 172
References: 36
Citations by year: 2026: 1 · 2025: 2 · 2024: 1 · 2023: 5 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 5 · 2015: 5 · 2014: 10 · 2013: 10 · 2012: 7
FWCI: 30.62
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
Keywords: atorvastatin, high-intensity statin therapy, heart failure hospitalization, stable coronary artery disease, statin dose comparison, secondary prevention, cardiovascular risk reduction
MeSH terms: Atorvastatin, Aged, Female, Follow-Up Studies, Heart Failure, Heptanoic Acids, Hospitalization, Humans, Male, Middle Aged, Pyrroles, Drug Delivery Systems

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Effect of High-Dose Atorvastatin on Hospitalizations for Heart Failure: Subgroup Analysis of the Treating to New Targets (TNT) Study

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