Background: Statin therapy is associated with improved survival in patients at high risk for cardiovascular mortality, but the impact of statin therapy among patients treated with trans-catheter aortic valve replacement (TAVR) is unknown.
Methods: We reviewed 294 consecutive cases of TAVR performed at a single center. High intensity statin therapy included atorvastatin 40-80 mg/day or rosuvastatin 20-40 mg/day. Study outcomes were post-TAVR adverse events, 30-day mortality, and overall survival.
Results: At the time of TAVR, 41 patients (14%) were on high intensity statin therapy, 173 patients (59%) were on low or moderate intensity statin therapy, and 80 patients (27%) were not on statin therapy. Society of Thoracic Surgeons projected 30-day mortality risk score was similar between groups. There was no association between statin therapy and the rate of post-TAVR stroke, myocardial infarction, acute kidney injury, in-hospital mortality, or 30-day mortality. At 2 years, 83% of patients in the high intensity statin group were alive, 70% in the low/moderate intensity statin group were alive, and 57% in the no statin group were alive (log-rank P=0.016). In a risk-adjusted model, high intensity statin therapy was associated with a 64% reduction in all-cause mortality (hazard ratio 0.36, 95% confidence interval 0.14 – 0.90, P=0.029) when compared to no statin therapy.
Conclusions: Statin therapy is associated with improved overall survival after TAVR in a dose dependent manner.