Abstract 533: Statin Use Is Associated With Improved Outcomes In Vascular Surgery Patients With Renal Impairment
BACKGROUND: Little is known about the association between baseline kidney function, statin therapy and outcome after vascular surgery in patients with and without chronic kidney disease.
METHODS: A total of 2,126 patients underwent elective vascular surgery and were divided in two categories, based on baseline creatinine clearance (CrCl); CrCl ≥60 mL/min (reference) and CrCl < 60 mL/min. Outcome measures were 30-day and long-term all-cause, cardiac and cerebro-cardiovascular mortality. Mean follow-up was 6.0 ± 3.7 years. Multivariate Cox regression analysis, including propensity score for statin-use, was applied. Data are presented as hazard ratios with 95% confidence interval.
RESULTS: 30-day all-cause, cardiac and cerebro-cardiovascular mortality rates were 4% vs. 10%, 1% vs. 4% and 3% vs. 8%, according to the two categories of kidney function. In addition, long-term mortality rates were 47% vs. 73%, 15% vs. 26% and 23 vs. 41%, respectively. Statin therapy was associated with an overall significant improved 30-day and long-term all-cause mortality, independent of other important confounders. However, in patients with a CrCl ≥ 60, the long-term cardiac and cerebro-cardiovascular beneficial effect did not reached statistical significance; HR 0.9, 0.6–1.4 and HR 0.9, 0.6 –1.2, when compared to patients with a CrCl of < 60 (HR 0.6, 0.4 – 0.9 and HR 0.7, 0.5– 0.9).
CONCLUSION: The level of kidney function is an independent predictor of short- and long-term outcome after non-cardiac surgery. In addition, perioperative statin-use in patients with kidney disease is associated with a reduction in the short- and long-term all-cause, cardiac and cerebro-cardiovascular mortality.