Abstract 1592: Statin Therapy Improves Long-Term Outcome in Patients with Reduced Renal Function and Left Ventricular Dysfunction Undergoing Percutaneous Coronary Intervention
Background. Prior studies have shown that high-risk patients with LV dysfunction had improved survival following PCI when discharged on statin therapy. However, the role of statins in patients with kidney disease is controversial. We sought to determine the impact of statin therapy on mortality following PCI in patients with LV dysfunction based on the degree of renal insufficiency.
Methods. Our retrospective analysis included consecutive patients undergoing PCI with a calculated LVEF≤50% between May 1996 and March 1999. Patients on dialysis were excluded. GFR was estimated using the simplified MDRD equation. Mortality data was retrieved using the US Social Security Death Index. Means are provided with SD and p-values <0.05 were considered significant.
Results. Our study included 325 patients with a mean EF of 38±10%. Twenty-two percent had moderate to severe chronic kidney disease (GFR<60 ml/min/1.73 m2) and 65% were on statins at the time of discharge. Over a 10-year follow-up, 41% of the patients died. Survival analysis at 1, 3, 5, and 9-years demonstrated that patients on statin therapy had significantly improved survival compared with patients that were not (1-year: 95% vs. 88%, p<0.001; 3-year: 88% vs. 72%, p<0.0001; 5-year: 80% vs. 65%, p<0.0001; 9-year: 67% vs. 45%, p<0.0001). Survival was significantly improved in patients on statins regardless of GFR (Figure 1⇓). Proportional hazard regression analysis demonstrated that GFR and statin therapy were both independently predictors of mortality.
Conclusion. In patients that underwent PCI with LV dysfunction, statin therapy was significantly associated with improved survival, especially in patients with kidney disease.