Impact of statin therapy on renal function and long-term prognosis in acute coronary syndrome patients with chronic kidney disease.
A recent study showed that statins reduce cardiovascular events in stable coronary artery disease patients with chronic kidney disease (CKD). However, it remains unclear whether acute coronary syndrome (ACS) patients with CKD benefit from statins. A total of 501 patients with ACS who underwent successful percutaneous coronary intervention were investigated and CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/minute/1.73 m(2) at discharge. Three hundred and twenty-four of 501 patients (64.7%) had CKD and 173 patients (34.5%) received statins. The patients with CKD were older and had higher blood pressure than those without CKD. With a mean follow-up of 5.2 years, irrespective of treatment assignment, 74 patients with CKD experienced cardiac events (22.8%) in comparison to 25 without CKD (14.1%, HR 1.81; 95% CI 1.15-2.84, P = 0.0095). Cardiac events occurred in only 18 of the patients with CKD treated with statins (16.2%) and in 56 of those treated with CKD without statins (26.3%, HR 0.58; 95% CI 0.34-0.98, P = 0.039), whereas, no significant reduction of the events was observed in the patients without CKD treated with statins versus without having statins (P = 0.130). These data indicate that statin therapy reduces cardiac events in ACS patients with CKD.
Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo, Japan.
Toshiyuki
T
Shibui
Akihiro
A
Nakagomi
Yoshiki
Y
Kusama
Hirotsugu
H
Atarashi
Kyoichi
K
Mizuno
D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D018572:Disease-Free Survival; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000453:epidemiology*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein