Impact of statin therapy on mortality and rehospitalization in acute heart failure patients stratified by ejection fraction: Insights from the Gulf CARE Registry

Authors

Mohammed Al-Jarallah, Division of Cardiology, Al-Dabous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait.
Rajesh Rajan, Division of Cardiology, Al-Dabous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait.
Raja Dashti, Division of Cardiology, Al-Dabous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait.
Bassam Bulbanat, Division of Cardiology, Al-Dabous Cardiac Centre, Al Adan Hospital, Kuwait City, Kuwait.
Mustafa Ridha, Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City, Kuwait.
Kadhim Sulaiman, Department of Cardiology, Royal Hospital, and Director General of Specialized Medical Care, Ministry of Health, Muscat, Oman.
Ibrahim Al-Zakwani, Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman & Gulf Health Research, Muscat, Oman.
Alawi A. Alsheikh-Ali, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Prashanth Panduranga, Department of Cardiology, Royal Hospital, Muscat, Oman.
Khalid F. Alhabib, Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia.
Jassim Al Suwaidi, Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates.
Wael Almahmeed, Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates.
Hussam Al Faleh, Department of Cardiac Sciences, King Fahad Cardiac Centre, King Saud University, Riyadh, Saudi Arabia.
Abdelfatah Elasfar, Department of Adult Cardiology, King Salman Heart Centre, King Fahad Medical City, Riyadh, Saudi Arabia, and Cardiology Department, Tanta University, Tanta, Egypt.
Ahmed Al-Motarreb, Department of Internal Medicine, Faculty of Medicine, Sana'a University, Sana'a, Yemen.
Nooshin Bazargani, Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates.
Nidal Asaad, Department of Adult Cardiology, Hamad Medical Corporation, Doha, Qatar.
Haitham Amin, Mohammed Bin Khalifa Cardiac Centre, Manama, Bahrain.
Zhanna Kobalava, Department of Internal Diseases with Courses of Cardiology and Functional Diagnostics, Peoples` Friendship University of Russia [RUDN University], Moscow, Russia.
Peter A. Brady, Advocate Health - MidwestFollow
Georgiana Luisa Baca, Department of Intramural Research Program, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States.
Parul Setiya, Department of Agrometeorology, College of Agriculture, G.B. Pant University of Agriculture & Technology, Pantnagar, Uttarakhand, India.
Ahmad R. Alsaber, Department of Management, College of Business and Economics, American University of Kuwait, 15 Salem Al Mubarak St., Salmiya, Kuwait.
Ghazaal Alavi Tabatabaei, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Joud Al Balool, Faculty of Medicine, Kuwait University, Kuwait.
Keanu Razzaghi, Department of Cardiology, McMaster University, Canada.

Recommended Citation

Al-Jarallah M, Rajan R, Dashti R, et al. Impact of Statin Therapy on Mortality and Rehospitalization in Acute Heart Failure Patients Stratified by Ejection Fraction: Insights from the Gulf CARE Registry. Curr Vasc Pharmacol. Published online April 30, 2025. doi:10.2174/0115701611311671250416054455

Affiliations

Illinois Masonic Medical Center

Abstract

Background:The prevalence and clinical outcomes of statin therapy in patients with acute heart failure [AHF] stratified by left ventricular ejection fraction [EF] in the Middle East are unknown.

Methods:We analysed 5005 patients admitted to 47 hospitals in seven Middle Eastern countries [Saudi Arabia, Oman, Yemen, Kuwait, United Arab Emirates, Qatar, and Bahrain] with AHF from February to November 2012 with AHF who were enrolled in Gulf CARE, a multinational registry of patients with heart failure [HF]. AHF patients were stratified into three groups: HF patients with reduced [EF] [HFrEF] [<40%], HF with mildly reduced EF [HFmrEF] [40-49%], and HF patients with preserved EF [HFpEF] [≥50%].

Results:The mean age of the cohort was 59.3±14.9 years, 62.6% [n=3131.0] of the patients were males. A total of 2555 [51%] AHF patients had used statins prior to hospital admission. The mean EF was 36.9±14%. HFrEF was observed in 2683 patients [53%], whereas 961 patients [19.2%] had HFmrEF, and 932 patients [18.6%] had HFpEF. Multivariate logistic regression analysis revealed that prior statin use was significantly associated with reduced in-hospital mortality risk [OR=1.43, 95% CI: 1.10-1.86, p=0.007] and hospitalization rates for heart failure [OR=0.71, 95% CI: 0.60-0.83, p<0.001]. However, when examining rates of survival, there were no significant disparities between the two groups; at 3 months follow-up: aOR, 1.22; 95% Cl: 0.95-1.57; P=0.111; and 12-months follow-up: aOR, 1.07; 95% Cl: 1.07 0.87-1.31; P=0.553. Regarding rehospitalization rates, no significant difference was observed at a 3- month follow-up: aOR, 1.22; 95% Cl: 1.03-1.42; P=0.015. Interestingly, patients admitted with statin therapy were significantly associated with higher odds of hospitalization during the 12-month follow-up period: aOR, 1.42; 95% Cl: 1.21-1.66; P<0.001.

Conclusion:Prior statin use was associated with a lower risk of in-hospital mortality and rehospitalization. However, there were no significant differences in all-cause mortality between the two groups at both 3- and 12-month follow-ups. While rehospitalization rates at the 3-month follow-up showed higher odds of rehospitalization at the 12-month follow-up. Prior statin therapy appears to influence both in-hospital mortality and long-term rehospitalization outcomes in a Middle Eastern patient population.

Type

Article

PubMed ID

40325528