Abstract 1428: Statin Use After Myocardial Iinfarction Improves Survival in Nearly All With Renal Dysfunction: Data From the Swedish Web-system for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)
Objective To assess survival benefit of statin use following a myocardial infarction (MI) across renal function stages.
Methods All consecutive MI patients who survived until discharge (n=53094) with available creatinine data registered in the nationwide SWEDEHEART database between 2003 and 2006 were included. Renal function (eGFR) was estimated with the Modification of Diet in Renal Disease Study formula and classified into National Kidney Foundation five renal function stages. The propensity to receive a statin at discharge within each renal function stage was obtained using logistic regression including 45 variables: baseline characteristics, in-hospital therapies and medication at discharge. One year survival was compared in patients discharged with and without statin in each renal function stage by Cox regression analysis adjusting for the propensity score.
Results The baseline characteristics in patients treated with and without statin at discharge was similar when adjusting for differences in propensity score. Statin use declined with each lower renal function stage: eGFR >=90: 84%; eGFR 60 – 89: 77%; eGFR 30 –59: 58%; eGFR 15–29: 44% and eGFR <15/dialysis: 53% (p<0.001). Use of statin decreased the risk of death overall by 30% (HR 0.70, 95% CI 0.66 – 0.75, p<0.001). The benefit on survival with statin was seen in all renal function groups (figure⇓) except those with renal failure (eGFR<15/dialysis).
Conclusion Statin benefits nearly all patients regardless of renal function after a MI, although the advantage is less certain in those with kidney failure.