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.
Original language | English (US) |
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Pages (from-to) | 570-580 |
Number of pages | 11 |
Journal | Pharmacoepidemiology and Drug Safety |
Volume | 27 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2018 |
Keywords
- heart failure
- left ventricular mass
- pharmacoepidemiology
- pleiotrophic
- statin
ASJC Scopus subject areas
- Epidemiology
- Pharmacology (medical)