title: Distinct impact of three different statins on arteriovenous fistula outcomes: a retrospective analysis.
abstract: OBJECTIVE
  Whether statins improve arteriovenous fistula (AVF) outcomes is still a matter of debate. Taking into consideration the existing physicochemical differences between individual drugs, this study evaluates the impact of three different statins (atorvastatin, rosuvastatin and simvastatin) on one-stage and two-stage AVF outcomes.
  
  
  METHODS
  Using a retrospective cohort of 535 patients, we analyzed the effects of each statin on primary failure and primary patency using multivariate logistic regressions and Cox proportional hazard models.
  
  
  RESULTS
  Out of the three statins analyzed, only atorvastatin improved the overall primary failure of AVF (odds ratio [OR] = 0.18, p = 0.005). Comparisons between the two AVF types demonstrated that this effect was due to a prominent reduction in primary failure of one-stage (OR = 0.03; p = 0.005), but not two-stage fistulas (OR = 0.43; p = 0.25). In contrast, primary patency of two-stage (hazards ratio [HR] = 0.51; p = 0.024), but not one-stage fistulas (HR = 0.98; p = 0.95), was improved by all statins as a group, but not by individual drugs.
  
  
  CONCLUSIONS
  Our results suggest that the potential benefit of statins on AVF outcomes is a drug-specific and not a class effect, and that such effect is also influenced by the type of fistula.
authors: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida - USA.
authors: Laisel
authors: L
authors: Martinez
authors: Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida - USA.
authors: Juan C
authors: JC
authors: Duque
authors: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida - USA.
authors: Luis A
authors: LA
authors: Escobar
authors: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida - USA.
authors: Marwan
authors: M
authors: Tabbara
authors: Department of Medicine, Jersey Shore University Medical Center, Hackensack-Meridian Health, Neptune, New Jersey - USA.
authors: Arif
authors: A
authors: Asif
authors: Section of Interventional Nephrology, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida - USA.
authors: Fadi
authors: F
authors: Fayad
authors: DeWitt Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida - USA.
authors: Roberto I
authors: RI
authors: Vazquez-Padron
authors: Division of Nephrology and Hypertension, Albany Medical College, Albany, New York - USA.
authors: Loay H
authors: LH
authors: Salman
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D000069059:Atorvastatin / Q000627:therapeutic use*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D000068718:Rosuvastatin Calcium / Q000627:therapeutic use*; D019821:Simvastatin / Q000627:therapeutic use*; D013997:Time Factors; D017211:Treatment Failure; D014654:Vascular Patency / Q000187:drug effects
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D019821:Simvastatin