title: Effect of statin on the 5 years clinical outcomes in dialysis patients treated with sirolimus-eluting stent.
abstract: OBJECTIVE
  The optimal medication therapies are recommended in patients with coronary artery disease even after the coronary revascularization. However, the information of optimal medical therapy in dialysis population is scant. We assessed the efficacy of statin on the clinical outcomes after Sirolimus-eluting stent (SES) implantation in patients with and without dialysis.
  
  
  RESULTS
  We analyzed date from 843 consecutive patients who successfully treated with SES in our institution between August 2004 and November 2006. Among patients, 96 patients (11.4%) were undergoing dialysis. In non-dialysis patients, 405 patients (54%) were treated with statin at hospital discharge. In dialysis patients, only 16 patients (17%) were treated with statin. In non-dialysis patients, mortality rate was significantly lower in patients treated with statin than those without statin (4.4% vs. 13.9%, p<0.0001). While in dialysis patients, mortality rate was similar between patients treated with and without statin (56.3% vs. 57.6%, p=0.86). After adjusting for confounders, the hazard ratios for mortality were 0.39 (95% confidence interval (CI), 0.14-0.99; p=0.047) in non-dialysis patients and 1.79 (95% CI, 0.39-7.86; 0.45) for dialysis patients. The interaction probability between statin use and dialysis for mortality was 0.016.
  
  
  CONCLUSIONS
  The use of statin may have beneficial effect on reducing mortality rate in patients after SES implantation in non-dialysis patients. However, such favorable effect was not observed in dialysis population.
authors.affiliation: Division of Cardiology, Tsuchiya General Hospital, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Kagawa
authors.forename: Mamoru
authors.initials: M
authors.lastname: Toyofuku
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Masaoka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Muraoka
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Okimoto
authors.forename: Masaya
authors.initials: M
authors.lastname: Otsuka
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Tamekiyo
authors.forename: Shinji
authors.initials: S
authors.lastname: Mito
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Kawase
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yamane
authors.forename: Michitaka
authors.initials: M
authors.lastname: Amioka
authors.forename: Nobuo
authors.initials: N
authors.lastname: Shiode
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D015415:Biomarkers; D002423:Cause of Death; D015897:Comorbidity; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D054855:Drug-Eluting Stents; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D020123:Sirolimus