Black patients less likely to receive statins after kidney transplant
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Compared with white patients, Black patients had lower odds of receiving statins for secondary cardiovascular disease prevention after kidney transplant.
Further, other underrepresented groups were less likely to receive aspirin compared with white patients.
“Black kidney transplant recipients have higher prevalence of cardiovascular disease (CVD) risk factors and less intensive risk factor control compared to white kidney transplant recipients,” Mohammad Kazem Fallahzadeh, MD, MAS, from the division of nephrology in the department of medicine at the University of California, San Francisco, and colleagues wrote. They added, “Although secondary CVD prevention with statins and aspirin has not been well-studied in kidney transplant recipients, the benefits of the secondary CVD prevention with these medications have been long well-established in the general population.”
In a post-hoc analysis, researchers assessed 978 kidney transplant recipients (78% were white patients; 17% were Black patients; 6% of patients were categorized as being in another racial group) from the U.S. or Canada enrolled in Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) to determine racial disparities in receipt of statins and aspirin for secondary cardiovascular disease prevention. All patients reported a history of CVD prior to study enrollment and were at least 6 months post-transplant.
Researchers followed patients every 6 months to measure CVD events, and follow-ups ended with death, loss to follow-up or on June 24, 2009. Using parametric, proportional hazards, interval censored survival models, researchers measured the independent correlation between race with receipt of statins and aspirin for secondary CVD prevention.
Analyses revealed Black or “non-white” race correlated with a lower odds of patients receiving statins and aspirin. Among statin users, 81% were white patients, 69% were Black patients and 77% were patients of another race. Similarly, among aspirin users, 79% were white patients, 68% were Black patients and 66% were patients of another race.
“Our results demonstrate that compared with white race, Black race was independently associated with a lower hazard of receiving statin, and other race was associated with a lower hazard of receiving aspirin among kidney transplant recipients with established CVD enrolled in FAVORIT,” Fallahzadeh and colleagues wrote. They added, “While over a decade old, these data highlight the importance of optimizing CVD risk reduction medications as they represent a potential target to improve CVD care in non-white kidney transplant recipients. Further research should examine modern patterns in CVD care delivery and factors contributing to racial disparities for deployment of targeted interventions.”
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