Document Detail


Renal Function and Effect of Statin Therapy on Cardiovascular Outcomes in Patients Undergoing Coronary Revascularization (from the CREDO-Kyoto PCI/CABG Registry Cohort-2).
MedLine Citation:
PMID:  22935527     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Although statin therapy is essential for secondary cardiovascular prevention, the therapeutic effect of statins on cardiovascular outcomes in patients with advanced chronic kidney disease (CKD) after coronary revascularization has not been fully elucidated. In the CREDO-Kyoto Registry Cohort-2, 14,706 patients who underwent first coronary revascularization were divided into 4 strata based on estimated glomerular filtration rate (eGFR) or status of hemodialysis (HD). Patients in each stratum were further divided into 2 groups based on statin therapy at discharge: non-CKD stratum (eGFR ≥60 ml/min/1.73 m(2)), 8,959 patients (statin, n = 4,747; no statin, n = 4,212); mild CKD stratum (eGFR ≥30 to <60 ml/min/1.73 m(2)), 4,567 patients (statin, n = 2,135; no statin, n = 2,432); severe CKD stratum (eGFR <30 ml/min/1.73 m(2)), 608 patients (statin, n = 229; no statin, n = 379); and HD stratum, 572 patients (statin, n = 117; no statin, n = 455). Median follow-up duration was 956 days (interquartile range 699 to 1,245). Adjusted risk for major adverse cardiovascular events (MACEs; composite of cardiovascular death, myocardial infarction, or stoke) was significantly lower in the statin group than in the no-statin group in the non-CKD (hazard ratio 0.8, 95% confidence interval 0.68 to 0.95, p = 0.01) and mild CKD (hazard ratio 0.69, 95% confidence interval 0.56 to 0.84, p = 0.0002) strata. However, a significant association of statin therapy and lower risk for MACEs was not seen in the severe CKD (hazard ratio 0.91, 95% confidence interval 0.6 to 1.38, p = 0.65) and HD (hazard ratio 1.04, 95% confidence interval 0.64 to 1.69, p = 0.87) strata. In conclusion, statin therapy was associated with significantly lower risk for MACEs in patients with non-CKD and mild CKD undergoing coronary revascularization. However, therapeutic benefits of statins were not apparent in patients with severe CKD and HD.
Authors:
Masahiro Natsuaki; Yutaka Furukawa; Takeshi Morimoto; Ryuzo Sakata; Takeshi Kimura;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-27
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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