Differential Effects of Strong and Regular Statins on the Clinical Outcome of Patients With Chronic Kidney Disease Following Coronary Stent Implantation　- The Kumamoto Intervention Conference Study (KICS) Registry.
BACKGROUND
The aim of this study was to examine the effects of different statins on the clinical outcomes of Japanese patients with coronary stent implants.


RESULTS
This study included 5,801 consecutive patients (males, 4,160; age, 69.7±11.1 years, mean±SD) who underwent stent implantation between April 2008 and March 2011. They were treated with a strong statin (n=3,042, 52%, atorvastatin, pitavastatin, or rosuvastatin), a regular statin (n=1,082, 19%, pravastatin, simvastatin, or fluvastatin) or no statin (n=1,677, 29%). The patients with chronic kidney disease (CKD) were divided into mild-to-moderate CKD (30≤eGFR<60, n=1,956) and severe CKD (eGFR <30, n=559). Primary endpoints included cardiovascular death and nonfatal myocardial infarction, including stent thrombosis and ischemic stroke. The clinical outcome for the primary endpoint in mild-to-moderate CKD patients treated with a strong statin (hazard ratio 0.50, 95% confidence interval 0.31-0.81; P=0.005) was significantly lower than in those on no statins, but that in the patients treated with a regular statin was not (P=0.160). The clinical outcome for the primary endpoint in severe CKD patients treated with a strong or regular statin was no different than not being on statin therapy (P=0.446, P=0.194, respectively).


CONCLUSIONS
In patients with mild-to-moderate CKD, only strong statins were associated with lower risk compared with no statin, but regular statins were not. It is possible that taking a strong statin from the early stage of CKD is useful for suppression of cardiovascular events.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University.
Masanobu
M
Ishii
Seiji
S
Hokimoto
Tomonori
T
Akasaka
Kazuteru
K
Fujimoto
Yuji
Y
Miyao
Koichi
K
Kaikita
Shuichi
S
Oshima
Koichi
K
Nakao
Hideki
H
Shimomura
Ryusuke
R
Tsunoda
Toyoki
T
Hirose
Ichiro
I
Kajiwara
Toshiyuki
T
Matsumura
Natsuki
N
Nakamura
Nobuyasu
N
Yamamoto
Shunichi
S
Koide
Hideki
H
Oka
Yasuhiro
Y
Morikami
Naritsugu
N
Sakaino
Kunihiko
K
Matsui
Hisao
H
Ogawa
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015607:Stents / Q000009:adverse effects*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors