This article is more than 5 years old. Information may no longer be current.
Study finds no significant link between statin intensity, all-cause mortality in veterans with CKD
Click Here to Manage Email Alerts
In a study of about 65,000 U.S. veterans with chronic kidney disease, investigators found no significant link between statin intensity for 1 year of exposure and 5-year all-cause mortality.
According to the researchers, their findings support current Kidney Disease: Improving Global Outcomes (KDIGO) guideline recommendations to use CKD population-specific statins and dosages vs. intensity-based dosing.
“The 2013 American College of Cardiology/American Heart Association lipid guideline recommends statin dosing based on intensity, rather than targeting specific low-density lipoprotein cholesterol (LDL-C) concentrations, among general populations,” Carl P. Walther, MD, of Baylor College of Medicine, and colleagues wrote. “The 2013 [KDIGO] lipid guidelines recommend statins for most adults with [CKD], but dose-dependent statin effects in CKD are unclear.”
Researchers performed a retrospective cohort study of 65,292 U.S. veterans with CKD stages G3a (eGFR 45 to 59 mL/min/1.73 m2), G3b (eGFR 30 to 44 mL/min/1.732) or G4 (eGFR 15 to 29 mL/min/1.732) and new, persistent statin use. Data was culled from 2005 to 2015. The objective of the study was to test the association of intensity of statin therapy – categorized as low (expected LDL-C reduction of <30%), medium (30% to <50%) or high ( to 50%) during the initial 1-year exposure period – with all-cause mortality during the subsequent 4 years.
Of the participants, 61.5% had CKD G3a; 30.9% had G3b; and 7.6% had G4. High-intensity statins, which were used in more recent years, were used by 7.5% of patients; 59.8% used moderate-intensity statins; and 32.7% used low-intensity statins.
“In this large cohort of U.S. veterans with moderate to advanced CKD who newly initiated statin treatment (and persisted for 1 year), statin intensity during the first year of use was not associated with subsequent all-cause mortality, over up to 5 years from statin initiation,” the researchers wrote. “Thus, our observational study does not support the general intensity-based recommendations by the 2013 [American College of Cardiology/American Heart Association] lipid treatment guideline for this specific sub-population with reduced eGFR, where data from head-to-head trials are sparse.” – by Jake Scott
Disclosures: Walther reports no relevant financial disclosures. Please see full study for all other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts