| Atorvastatin and Low-Density Lipoprotein Cholesterol in Type 2 Diabetes Mellitus Patients on Hemodialysis. | |
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MedLine Citation:
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PMID: 21493741 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Summary Background and objectives Patients undergoing maintenance hemodialysis are at high cardiovascular risk. Lowering LDL-cholesterol with statins reduces the incidence rate of cardiovascular events in patients with chronic kidney disease. In contrast, two randomized, prospective, placebo-controlled trials have been completed in hemodialysis patients that showed no significant effects of statins on cardiovascular outcomes. Design, setting, participants, & measurements A post hoc analysis was conducted of the 4D (Die Deutsche Diabetes Dialyze) study to investigate whether LDL-cholesterol at baseline is predictive of cardiovascular events and whether the effect of atorvastatin on clinical outcomes depends on LDL-cholesterol at baseline. Results High concentrations of LDL-cholesterol by tendency increased the risks of cardiac endpoints and all-cause mortality. Concordantly, atorvastatin significantly reduced the rates of adverse outcomes in the highest quartile of LDL-cholesterol (≥145 mg/dl, 3.76 mmol/L). The hazard ratios and 95% confidence intervals were 0.69 (0.48 to 1.00) for the composite primary endpoint, 0.58 (0.34 to 0.99) for cardiac death, 0.48 (0.25 to 0.94) for sudden cardiac death, 0.62 (0.33 to 1.17) for nonfatal myocardial infarction, 0.68 (0.47 to 0.98) for all cardiac events combined, and 0.72 (0.52 to 0.99) for death from all causes, respectively. No such decrease was seen in any of the other quartiles of LDL-cholesterol at baseline. Conclusions In patients with type 2 diabetes mellitus undergoing hemodialysis, atorvastatin significantly reduces the risk of fatal and nonfatal cardiac events and death from any cause if pretreatment LDL-cholesterol is >145 mg/dl (3.76 mmol/L). |
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Authors:
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Winfried März; Bernd Genser; Christiane Drechsler; Vera Krane; Tanja B Grammer; Eberhard Ritz; Tatjana Stojakovic; Hubert Scharnagl; Karl Winkler; Ingar Holme; Hallvard Holdaas; Christoph Wanner; |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-14 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: - ISSN: 1555-905X ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Heidelberg, Germany; |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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