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A statin in the treatment of heart failure? Controlled rosuvastatin multinational study in heart failure (CORONA): Study design and baseline characteristics

Authors: John Kjekshus; Peter H.J.M. Dunselman; Malin Blideskog; Christina Eskilson; Åke Hjalmarson; John V. McMurray; Finn Waagstein; +3 Authors

A statin in the treatment of heart failure? Controlled rosuvastatin multinational study in heart failure (CORONA): Study design and baseline characteristics

Abstract

Background: Previous prospective outcome studies of statins have not provided any guidance on benefit-risk in patients with heart failure. Aim: The primary objective is to determine whether rosuvastatin (10 mg) reduces the combined endpoint of cardiovascular mortality, nonfatal myocardial infarction or non-fatal stroke (time to first event). The first secondary endpoint is all-cause mortality. Methods: CORONA is a randomized, double-blind, placebo-controlled trial. Briefly, men and women, aged 60 years with chronic symptomatic systolic heart failure of ischemic aetiology and ejection fraction 0.40 (NYHA class III and IV) or 0.35 (NYHA class II) were eligible if they were not using or in need of cholesterol lowering drugs. Results: Mean age was 73 years (n=5016; 24% women), with 37% in NYHA II and 62% in NYHA III, ejection fraction 0.31, total cholesterol 5.2 mmol/L. Sixty percent have a history of myocardial infarction, 63% hypertension, and 30% diabetes. Patients are well treated for heart failure with 90% on loop or thiazide diuretics, 42% aldosterone antagonists, 91% ACE inhibitor or AT-I blocker, 75% beta-blockers, and 32% digitalis. Conclusion: CORONA is important for three main reasons: (1) A positive result is very important because of the high risk of the population studied, the increasing prevalence of elderly patients with chronic symptomatic systolic heart failure in our society, and the health economic issues involved. (2) If negative, new mechanistic questions about heart failure have to be raised. (3) If neutral we can avoid unnecessary polypharmacy.

Subjects by Vocabulary

Microsoft Academic Graph classification: medicine.medical_specialty Population Internal medicine medicine Rosuvastatin Myocardial infarction education Stroke education.field_of_study Ejection fraction business.industry medicine.disease Rosuvastatin Calcium Heart failure ACE inhibitor Cardiology business medicine.drug

Keywords

Male, International Cooperation, Hypercholesterolemia, Risk Assessment, Severity of Illness Index, Drug Administration Schedule, Double-Blind Method, Humans, Prospective Studies, Rosuvastatin Calcium, Aged, Probability, Heart Failure, Sulfonamides, Dose-Response Relationship, Drug, Age Factors, Middle Aged, Survival Analysis, Fluorobenzenes, Pyrimidines, Treatment Outcome, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, Follow-Up Studies

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 1%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
  • citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    125
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 1%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
125
Top 10%
Top 1%
Top 1%
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