Abstract 389: Effect of Statin Treatment on Carotid Atherosclerosis in Patients with Stable Coronary Artery Disease Stratified by Renal Function
Background: Chronic kidney disease (CKD) is common in older patients with coronary artery disease, and such patients have adverse outcomes. The purpose of the present study was to investigate the efficacy of cholesterol lowering treatment with a statin in modifying carotid atherosclerosis in patients with stable coronary artery disease stratified by glomerular filtration rate (GFR).
Methods: Eighty-nine patients with stable coronary artery disease were stratified into 3 baseline GFR groups: normal or increased (≥90 ml/min/1.73m2; n=35 patients), mild reduction (60 to 89 ml/min/1.73m2; n=43 patients), and moderate or severe reduction (<60 ml/min/1.73m2; n=11 patients). Patients underwent carotid ultrasonography at baseline and 10 months after statin treatment, and mean intima-media thickness (IMT) of the distal common carotid artery was measured using manual tracing software by a single sonographer blinded to patient renal function. The absolute difference of replicate scans of IMT in our institution is 0.06 mm.
Results: LDL cholesterol and CRP levels were similar in the three groups at baseline and after statin treatment. Compared with patients with normal GFR, patients with moderate or severe GFR showed significant reduction in mean IMT after adjustment for percent LDL cholesterol reduction (Figure⇓).
Conclusion: Among coronary artery disease patients, those with moderate or severe CKD benefited more from statin treatment than did patients with mild or no CKD. However, this benefit may not be attributed to the reduction of LDL cholesterol by statin treatment.