Lauren N Strand1, Rebekah L Young2, Alain G Bertoni3, David A Bluemke4,5, Gregory L Burke6, Joao A Lima7, Nona Sotoodehnia8,9, Bruce M Psaty8,10,11, Robyn L McClelland2, Susan R Heckbert8,10, Joseph A Delaney2,10. 1. Department of Pharmacy, University of Washington, WA, USA. 2. Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA, USA. 3. Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA. 4. National Institutes of Health Clinical Center, Bethesda, MD, USA. 5. National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA. 6. Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA. 7. Johns Hopkins School of Medicine, Baltimore, MD, USA. 8. Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA. 9. Department of Cardiology, University of Washington, Seattle, WA, USA. 10. Department of Epidemiology, University of Washington, Seattle, WA, USA. 11. Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA.
Abstract
PURPOSE: Only small and short-term studies have evaluated statins in relation to changes in heart structure. We estimated the association between new statin use and 10-year remodeling of the left ventricle. METHODS: The Multi-Ethnic Study of Atherosclerosis collected data on statin use over approximately 10 years, conducting cardiac magnetic resonance (CMR) imaging at baseline and the 10-year exam. Participants were free of baseline cardiovascular disease, and we excluded users of statins at baseline. Statin initiation was defined as a report of current use at any of the 4 subsequent exams. Primary outcomes were the change in left ventricular mass index (LVMI; % predicted by height, weight, and sex) and mass-to-volume ratio. Associations were estimated in a propensity score-matched analysis. RESULTS: A total of 3113 participants (53% female; 40% European-American, 25% African-American, 22% Hispanic-American, and 13% Chinese-American) were eligible; 2431 returned for follow-up CMR imaging after a median of 9.4 years. Statin therapy (moderate dose, 76%) was started by 36% of participants (N = 872). We excluded 42 participants with incident myocardial infarction. Compared with nonuse, statin use was associated with less 10-year progression in LVMI (-2.35 percentage points; 95% CI, -4.24 to -0.47; P = .01) and mass-to-volume ratio (-0.03 absolute difference; 95% CI, -0.07 to -0.00; P = .02); effects were small in magnitude. A dose response was observed: Higher statin dose was associated with less LVMI progression. CONCLUSIONS: In contrast to previous small studies, we found very modest associations between statin use and indices of left ventricular remodeling over 10 years in this prospective study of a diverse cohort.
PURPOSE: Only small and short-term studies have evaluated statins in relation to changes in heart structure. We estimated the association between new statin use and 10-year remodeling of the left ventricle. METHODS: The Multi-Ethnic Study of Atherosclerosis collected data on statin use over approximately 10 years, conducting cardiac magnetic resonance (CMR) imaging at baseline and the 10-year exam. Participants were free of baseline cardiovascular disease, and we excluded users of statins at baseline. Statin initiation was defined as a report of current use at any of the 4 subsequent exams. Primary outcomes were the change in left ventricular mass index (LVMI; % predicted by height, weight, and sex) and mass-to-volume ratio. Associations were estimated in a propensity score-matched analysis. RESULTS: A total of 3113 participants (53% female; 40% European-American, 25% African-American, 22% Hispanic-American, and 13% Chinese-American) were eligible; 2431 returned for follow-up CMR imaging after a median of 9.4 years. Statin therapy (moderate dose, 76%) was started by 36% of participants (N = 872). We excluded 42 participants with incident myocardial infarction. Compared with nonuse, statin use was associated with less 10-year progression in LVMI (-2.35 percentage points; 95% CI, -4.24 to -0.47; P = .01) and mass-to-volume ratio (-0.03 absolute difference; 95% CI, -0.07 to -0.00; P = .02); effects were small in magnitude. A dose response was observed: Higher statin dose was associated with less LVMI progression. CONCLUSIONS: In contrast to previous small studies, we found very modest associations between statin use and indices of left ventricular remodeling over 10 years in this prospective study of a diverse cohort.
Authors: David Preiss; Sreenivasa Rao Kondapally Seshasai; Paul Welsh; Sabina A Murphy; Jennifer E Ho; David D Waters; David A DeMicco; Philip Barter; Christopher P Cannon; Marc S Sabatine; Eugene Braunwald; John J P Kastelein; James A de Lemos; Michael A Blazing; Terje R Pedersen; Matti J Tikkanen; Naveed Sattar; Kausik K Ray Journal: JAMA Date: 2011-06-22 Impact factor: 56.272
Authors: Shunsuke Natori; Shenghan Lai; J Paul Finn; Antoinette S Gomes; W Gregory Hundley; Michael Jerosch-Herold; Gregory Pearson; Shantanu Sinha; Andrew Arai; Joao A C Lima; David A Bluemke Journal: AJR Am J Roentgenol Date: 2006-06 Impact factor: 3.959
Authors: R J Folkeringa; C de Vos; Y M Pinto; J Habets; P W De Leeuw; R G Tieleman; M H Prins; M Van Dieijen-Visser; H J G M Crijns Journal: Int J Cardiol Date: 2009-08-26 Impact factor: 4.164
Authors: J Bauersachs; S Störk; M Kung; C Waller; F Fidler; C Hoyer; S Frantz; F Weidemann; G Ertl; C E Angermann Journal: Eur J Clin Invest Date: 2007-11 Impact factor: 4.686
Authors: Samuel S Gidding; Kiang Liu; Laura A Colangelo; Nakela L Cook; David C Goff; Stephen P Glasser; Julius M Gardin; Joao A C Lima Journal: Circ Cardiovasc Imaging Date: 2013-08-06 Impact factor: 7.792