Metabolic syndrome and cardiovascular risk in renal transplant recipients: effects of statin treatment.
BACKGROUND
Renal transplant recipients (RTR) have high risk for cardiovascular disease (CVD). They also have high prevalence of insulin resistance and metabolic syndrome (MS). Statin treatment reduces CVD risk in RTR. The aim was to study MS as CVD risk factor in RTR, and to investigate the effect of statin treatment in RTR with MS.


METHODS
In total, 1706 non-diabetic RTR from the Assessment of Lescol in Renal Transplantation trial were followed for 7-8 yr. The captured endpoints included major adverse cardiac events [MACE, defined as cardiac death (CD), non-fatal myocardial infarction or coronary revascularization procedure], and CD. MS was defined at baseline according to Adult Treatment Panel III definition with waist girth replaced by body mass index > or =30 kg/m2.


RESULTS
MS was diagnosed in 32% of the patients. During the follow-up, MACE incidence was 16% in those with MS and 11% in those without MS (p < 0.001). Statin treatment reduced MACE risk by 53% in the group with MS. CD risk was 74% higher in RTR with MS (p = 0.012), and statin treatment reduced CD risk in those with MS (p = 0.03).


CONCLUSIONS
RTR with MS have increased risk for CVD. RTR with MS are an easily identifiable group of patients who benefit from statin treatment.
Soveri
Inga
I
Department of Medical Sciences, Uppsala University, Uppsala, Sweden. inga.soveri@medsci.uu.se
Abedini
Sadollah
S
Holdaas
Hallvard
H
Jardine
Alan
A
Eriksson
Niclas
N
Fellström
Bengt
B
D000975:Antioxidants; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D000077340:Fluvastatin; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D015994:Incidence; D007211:Indoles / Q000008:administration & dosage / Q000627:therapeutic use*; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000601:surgery; D016030:Kidney Transplantation; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000975:Antioxidants; D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D008055:Lipids; D000077340:Fluvastatin