The beneficial effects of statins in patients undergoing hemodialysis.
BACKGROUND
The beneficial effects of statins in patients undergoing hemodialysis are controversial. Our study aimed to investigate the use of statins and the subsequent risk of cardiovascular morbidity and mortality in patients undergoing hemodialysis.


METHODS
We conducted a cohort study using data from the Taiwan National Health Insurance Research Database. Cox regressions were performed to determine the hazard ratio (HR) of cardiovascular morbidity and mortality in the HD patients taking statins (statin cohort) compared with a propensity-matched comparison cohort.


RESULTS
The statin cohort included a total of 4074 patients who received statin treatment while also undergoing hemodialysis (mean age 53.3 ± 13.5 years, male 34.9%). The comparison cohort included 8148 propensity-matched hemodialysis patients who were not using statins. During the three years of follow-up, the statin cohort had lower incidence of ischemic stroke (p < 0.001), hospitalizations due to unstable angina (p < 0.001), deep vein thrombosis (p < 0.001), cardiovascular mortality (p < 0.001), and all-cause mortality (p < 0.001). After Cox regression analysis, statin use was independently associated with lower risk of future ischemic stroke (HR, 0.49; 95% confidence interval [CI], 0.39-0.63), hospitalization for unstable angina (HR, 0.57; 95% CI, 0.47-0.70), deep vein thrombosis (HR, 0.11; 95% CI, 0.05-0.27), cardiovascular mortality (HR, 0.29; 95% CI, 0.18-0.46), and all-cause mortality (HR, 0.49; 95% CI, 0.41-0.58).


CONCLUSIONS
Statin use was associated with a lower incidence of cardiovascular morbidity and mortality in patients undergoing hemodialysis.
Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, R.O.C.; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan, R.O.C.
Chin-Chou
CC
Huang
Wan-Leong
WL
Chan
Yu-Chun
YC
Chen
Tzeng-Ji
TJ
Chen
Chia-Min
CM
Chung
Po-Hsun
PH
Huang
Shing-Jong
SJ
Lin
Jaw-Wen
JW
Chen
Hsin-Bang
HB
Leu
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000639:trends*; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiovascular; Hemodialysis; Morbidity; Mortality; Statins