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• W2320220594 abstract "Purpose: Results from some observational studies and subgroup analysis of recent randomized controlled trials suggested the existence of a subgroup of patients with heart failure that benefit from statins. The present study was a sub-study of the pitavastatin heart failure study (PEARL) designed to explore the useful biomarkers for detecting the patients who benefit from statins prospectively. High sensitivity cardiac troponin T (hs-cTnT) is considered to detect a chronic low-grade leak of cardiac troponin, which was known as an on-going myocardial damage, and statins have the potential to be effective in this condition.Methods: Of 574 PEARL study participants with heart failure (NYHA class II-III, LVEF<45%) who were randomly allocated to a pitavastatin (2mg/day adjunct to an optimal medical therapy) or control (optimal medical therapy only) group, 242 patients agreed to participate in this study for biomarkers. The plasma hs-cTnT and other several biomarkers were measured at baseline and three months after enrollment, and followed up for 35.5 months.Results: There were no significant differences in baseline characteristics including age, sex, NYHA functional class, LVEF, type of medications, NT-proBNP, and hs-cTnT levels between in pitavastatin-treated (n=121) and control patients (n=121). A significant reduction of the primary outcomes, which were a composite of cardiac death and hospitalization for worsening heart failure, was observed in the pitavastatin group, only in patient with LVEF≥30% (hazard ratio; HR 0.392, 95% confidence interval; CI 0.169-0.909, P=0.029). This result was consistent with the principal findings from PEARL main study. Therefore, we compared pitavastatin-treated patients with control group in patients with LVEF≥30% according to baseline plasma hs-cTnT levels>12.4ng/L or ≤12.4ng/L (above or below median). Patients in the hs-cTnT>12.4ng/L category had significantly increased risk for the primary outcomes (HR 2.965, 95% CI 1.23-7.16, P=0.011). Adding plasma hs-cTnT levels to LVEF improved risk prediction parameters. Additionally, in the hs-cTnT>12.4ng/L category, 12 control (32.4%) and 5 pitavastatin-treated (11.1%) patients had a primary outcome (HR 0.27; 95% CI 0.09-0.77, P=0.009). By contrast, in the hs-cTnTs≤12.4ng/L category, 5 control (9.6%) and 2 pitavastatin-treated (4.7%) patients experienced these outcomes (HR 0.435; 95% CI 0.08-2.24, P=0.31).Conclusions: It was suggested that a higher plasma hs-cTnT level might be associated with the effectiveness of pitavastatin treatment in heart failure patients with LVEF≥30%." @default.
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• W2320220594 date "2013-08-02" @default.
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• W2320220594 title "High-sensitivity assay of plasma cardiac troponin T predicts the effects of pitavastatin in patients with chronic heart failure: a sub-group analysis from the pitavastatin heart failure study (PEARL)" @default.
• W2320220594 doi "https://doi.org/10.1093/eurheartj/eht309.p3294" @default.
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