title: Statin therapy associated with a reduced risk of chronic renal failure after cardiac transplantation.
abstract: BACKGROUND
  Chronic renal failure (CRF) after heart transplantation is common, although risk factors for its development and potential preventive interventions are not well established.
  
  
  METHODS
  In this study we retrospectively assessed the cumulative incidence of CRF and identified independent predictors of CRF in heart transplant recipients between August 1986 and January 2003.
  
  
  RESULTS
  Among the 218 patients included in the analysis, the cumulative incidence of CRF was 4.5% at 5 years, and 19.6% at 10 years after transplant. Multivariate Cox modeling revealed that diabetes mellitus prior to transplant was associated with an increased risk of CRF (hazards ratio [HR] 7.11, p < 0.01), whereas factors associated with a reduced risk of CRF included a pre-transplant creatinine clearance > or = 60 ml/min/1.73 m2 (HR 0.30, p = 0.01) and treatment with a statin after transplant (HR 0.25, p < 0.01). Patients who developed CRF after transplant were at higher risk of death (HR 8.5, p < 0.01).
  
  
  CONCLUSIONS
  CRF is common after cardiac transplantation and is associated with substantial mortality. The reduced risk of CRF observed with statin therapy warrants prospective study, with particular emphasis on the mechanisms of progression to CRF in this population.
authors.affiliation: Zena and Michael Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, New York, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Lubitz
authors.forename: Sean
authors.initials: S
authors.lastname: Pinney
authors.forename: Juan P
authors.initials: JP
authors.lastname: Wisnivesky
authors.forename: Alan
authors.initials: A
authors.lastname: Gass
authors.forename: David A
authors.initials: DA
authors.lastname: Baran
mesh_terms: D000328:Adult; D001794:Blood Pressure; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008074:Lipoproteins