Effects of statin treatment in patients with coronary artery disease and chronic kidney disease

Heart Vessels. 2014 Jan;29(1):21-8. doi: 10.1007/s00380-013-0325-2. Epub 2013 Feb 21.

Abstract

Statins reduce cardiovascular morbidity and mortality from coronary artery disease (CAD). However, the effects of statin therapy in patients with CAD and chronic kidney disease (CKD) remain unclear. Within a single hospital-based cohort in the Shinken Database 2004-2010 comprising all patients (n = 15,227) who visited the Cardiovascular Institute, we followed patients with CKD and CAD after percutaneous coronary intervention (PCI). A major adverse cardiovascular and cerebrovascular event (MACCE) was defined by composite end points, including death, myocardial infarction, cerebral infarction, cerebral hemorrhage, and target lesion revascularization. A total of 391 patients were included in this study (median follow-up time 905 ± 679 days). Of these, 209 patients used statins. Patients with statin therapy were younger than those without. Obesity and dyslipidemia were more common, and the glomerular filtration rate (GFR) was significantly higher, in patients undergoing statin treatment. MACCE and cardiac death tended to be less common, and all-cause death was significantly less common, in patients taking statins. Multivariate analysis showed that low estimated GFR, poor left ventricular ejection fraction, and the absence of statin therapy were independent predictors for all-cause death of CKD patients after PCI. Statin therapy was associated with reduced all-cause mortality in patients with CKD and CAD after PCI.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cerebrovascular Disorders / epidemiology
  • Chi-Square Distribution
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy
  • Dyslipidemias / blood
  • Dyslipidemias / diagnosis
  • Dyslipidemias / drug therapy*
  • Dyslipidemias / epidemiology
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Kidney / physiopathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / epidemiology
  • Obesity / epidemiology
  • Percutaneous Coronary Intervention
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / mortality
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Factors
  • Stroke Volume
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors