Clinical InvestigationCongestive Heart FailureClass effects of statins in elderly patients with congestive heart failure: A population-based analysis
Section snippets
Data sources
Data on the treatment and clinical outcomes of all patients aged ≥65 years who were admitted for CHF in Quebec, Ontario, and British Columbia (BC) (the 3 most populous provinces in Canada) between January 1, 1998, and December 31, 2002, were obtained from government administrative databases in each province and merged for this analysis.
The hospital discharge summary databases used to identify patients with CHF in Quebec, Ontario, and BC are respectively called the following: Maintenance et
Study sample
The initial merged dataset was composed of 206 423 patients hospitalized with newly diagnosed CHF. The final sample of 15 368 patients was selected after the exclusion of 84 396 patients with previous CHF admissions, 19 376 patients aged <65 or >105 years, 13 758 who died in hospital, 4459 who were discharged to long-term care hospitals, 3930 who transferred from another hospital, 895 who were not admitted to an acute care hospital, 896 who presented CHF as a complication, 874 nonprovince residents,
Discussion
In this elderly population with newly diagnosed CHF, we observed no difference in effectiveness between 4 commonly used statin agents (atorvastatin, simvastatin, lovastatin, pravastatin) in the prevention of mortality. These observations were robust and independent of the way the drug dosage variable was used in models. We also observed no differential effectiveness across all 4 statin agents when restricting the dataset to patients without definite evidence of CAD (previous MI, PCI, or CABG),
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Supported by grants from the Canadian Institutes of Health Research (#MOP53181, MOP19671).