Pulmonary hypertension (PH) patients who take statins live longer than those who don’t — despite similar histories of hospitalization in both groups.
That’s the conclusion of a retrospective analysis by researchers at New York’s Albert Einstein College of Medicine, who also found that statin use had no effect on survival rates in people with advanced chronic obstructive pulmonary disease (COPD). The report, “Statin therapy improves survival in patients with severe pulmonary hypertension: a propensity score matching study,” appeared in the journal Heart and Vessels. It urges clinical trials to explore statin treatment in PH.
Statins have been extensively studied in animal models of lung hypertension, and experiments showed that these drugs — used to lower blood cholesterol levels — affect key processes in lung hypertension development. But there isn’t much patient data, which is why researchers analyzed 2,363 adult patients with severe PH and preserved left heart function.
Only 6 percent of patients were treated with statins. These people were more likely to have diabetes, high blood fats or heart disease — and also were more often treated with other drugs for these conditions. To makes the groups more similar, the research team matched patients with and without statins. Their analysis of the 138 statin-treated patients and 624 statin-free patient controls revealed that within one year, 15.2 percent of those treated with a statin had died, compared to 33.8 percent in the statin-free group.
That translates into statin use slashing the risk of death by 58 percent. In fact, when looking back at the entire non-matched group, researchers saw similar effects — with a 64 percent relative risk reduction in the statin group. Hospitalizations during the one-year period, however, occurred to a similar extent in both groups.
Since COPD reduces survival rates in PH patients, the team analyzed patients with and without the condition; 212 patients in the matched groups had COPD. Findings revealed that statin use lowered mortality in patients without COPD, while those with the condition saw no survival benefits. A statistical analysis did not, however, find that COPD affected survival after statin use.
One possible explanation to these somewhat surprising results may be that the studied patients were all in advanced disease stages. At that point, the team argued, it may be too late for statins to make much of a difference.
“In this retrospective multi-center propensity score matching study, statin therapy is associated with reduced 1-year mortality risk in patients with severe PH and preserved left ventricular function,” researchers concluded. “This beneficial effect was not found to be dependent on COPD status. These novel findings should be confirmed in large randomized trials.”