Park CS, Hwang IC, Park JJ, et al. - Statins-induced survival benefit was found to be confined to patients with heart failure (HF) with preserved ejection fraction (HFpEF) and those with ischemic HF. In HF patients, the prognostic impacts of statins may be modulated by myocardial contractility, especially in the presence of ischemic rather than non-ischemic etiology.

• This study included 1680 acute HF patients taking statins and 2157 patients not taking statins, observed for 5 year all-cause mortality (primary outcome).

• An independent association of statin therapy with improved survival was found in patients with HFpEF [adjusted hazard ratio (HR) 0.781].

• Statins-induced mortality reduction was significant in ischemic HF (adjusted HR 0.775), but not in non-ischemic HF (adjusted HR 0.895).

• With increasing LV-EF (left ventricular-ejection fraction) and LV-GLS (left ventricular global longitudinal strain), an increase in the relative magnitude of survival benefit with statin therapy was evident, with a steeper dose–response link in those with ischemic HF.

• Survival advantage with statin treatment was confined to those ≤75 years of age in the subgroup of patients with ischemic HF.