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Int J Angiol 2015; 24(02): 105-112
DOI: 10.1055/s-0035-1547373
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Survival Benefit of Statins in Hemodialysis Patients Awaiting Renal Transplantation

Waqas Aftab
1   Division of Cardiovascular Medicine, Loma Linda University Medical Center, Loma Linda, California
,
Juliana Gazallo
1   Division of Cardiovascular Medicine, Loma Linda University Medical Center, Loma Linda, California
,
Ali Motabar
1   Division of Cardiovascular Medicine, Loma Linda University Medical Center, Loma Linda, California
,
Padmini Varadrajan
1   Division of Cardiovascular Medicine, Loma Linda University Medical Center, Loma Linda, California
,
Prakash C. Deedwania
2   UCSF Fresno Medical Education and Research, Fresno, California
,
Ramdas G. Pai
1   Division of Cardiovascular Medicine, Loma Linda University Medical Center, Loma Linda, California
› Author Affiliations
Further Information

Publication History

Publication Date:
23 March 2015 (online)

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Abstract

End-stage renal disease (ESRD) patients have extraordinarily high cardiovascular risk and mortality, yet the benefit of statins in this population remains unclear based on the randomized trials. We investigated the prognostic value of statins in a large, pure cohort of prospectively recruited patients with ESRD awaiting renal transplantation, and being followed up in a dedicated cardiac clinic.

We prospectively collected demographic, clinical, laboratory, and pharmacological data on 423 consecutive ESRD patients on hemodialysis awaiting renal transplantation. Survival analysis was performed as a function of statin therapy.

The baseline characteristics were as follows: age 57 ± 11 years, males 64%, diabetes mellitus in 68%, known coronary artery disease in 30%, left ventricular (LV) ejection fraction 61 ± 11%. Over a mean follow-up of 2 years, there were 43 deaths. Adjusted for age, gender, hypertension, body mass index, diabetes mellitus, coronary artery disease, smoking, and treatment with angiotensin converting enzyme inhibitor, β blocker, and antiplatelet medications, statin use was a predictor of lower mortality (hazard ratio 0.30, 95% confidence interval 0.11–0.79, p = 0.01). This beneficial effect of statin was supported by propensity score analysis (p = 0.02) and was consistent across all clinical subgroups. The benefit of statins seemed to be greater in those with LV hypertrophy and smoking.

Statin therapy in hemodialysis patients awaiting renal transplant is independently associated with better survival supporting its use in this high-risk population.

Keywords

end-stage renal disease - statin - survival - hemodialysis - diabetes

Note

Abstract presented at: Annual Scientific Session of American Heart Association; November 3–7, 2012; Los Angeles, CA. Abstract 12517.


 

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