title: Effect of lovastatin on primary prevention of cardiovascular events in mild CKD and kidney function loss: a post hoc analysis of the Air Force/Texas Coronary Atherosclerosis Prevention Study.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is associated with an increased risk of incident cardiovascular disease (CVD); however, the role of statins for the primary prevention of acute cardiovascular events in patients with CKD and the effect of statins on kidney function loss in persons without prevalent CVD have not been studied.
  
  
  METHODS
  Post hoc analysis of the Air Force/Texas Coronary Atherosclerosis Prevention Study.
  
  
  METHODS
  Multicenter, randomized, double-blind, placebo-controlled trial of 5,608 men and 997 women without CVD randomly assigned to treatment with lovastatin or placebo.
  
  
  METHODS
  Placebo or lovastatin, 20 mg/d.
  
  
  METHODS
  First major acute cardiovascular event in participants with mild CKD and kidney function loss in persons with or without CKD. Estimated glomerular filtration rate was calculated using the 4-variable Modification of Diet in Renal Disease Study equation.
  
  
  RESULTS
  At baseline, mean estimated glomerular filtration rate in participants with CKD (n = 304) was 53.0 +/- 6.0 mL/min/1.73 m(2). After an average follow-up of 5.3 +/- 0.8 years, the incidence of a fatal and nonfatal CVD event was lower in participants with CKD receiving lovastatin than in those receiving placebo (adjusted relative risk [RR], 0.31; 95% CI, 0.13-0.72; P = 0.01). Tests for interaction suggested that the benefit of lovastatin was independent of the presence of CKD. Lovastatin did not reduce the annualized mean decrease in estimated glomerular filtration rate (-1.3 +/- 0.07 vs -1.4 +/- 0.07 mL/min/1.73 m(2)/y, respectively; P = 0.1) or the frequency of a > or = 25% decrease in kidney function (adjusted RR, 1.10; 95% CI, 0.96-1.28; P = 0.2) or incident CKD (adjusted RR, 1.04; 95% CI, 0.86-1.27; P = 0.6).
  
  
  CONCLUSIONS
  Unable to determine the cause and duration of kidney disease, and information regarding proteinuria was not available.
  
  
  CONCLUSIONS
  Lovastatin is effective for the primary prevention of CVD in patients with CKD, but is not effective in decreasing kidney function loss in persons with no CVD.
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado Denver Health Sciences Center, Aurora, CO 80220, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kendrick
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
authors.forename: Thomas
authors.initials: T
authors.lastname: Cook
authors.forename: Joann
authors.initials: J
authors.lastname: Lindenfeld
authors.forename: Michel
authors.initials: M
authors.lastname: Chonchol
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology; D007677:Kidney Function Tests / Q000379:methods*; D008148:Lovastatin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D011322:Primary Prevention / Q000379:methods*; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008148:Lovastatin