Abstract 8888: Statin Therapy In Patients with Chronic Kidney Disease Undergoing Percutaneous Coronary Interventions Is Associated with Better One Year Outcomes. An Analysis from the Evaluation of Drug Eluting Stents and Ischemic Events (EVENT) Registry
Background: Primary and secondary prevention trials have shown that statin therapy reduces cardiovascular morbidity and mortality in patients with coronary artery disease. However, there has been a paucity of data concerning the benefits of statin use in patients with advanced chronic kidney disease (CKD) since they have been excluded from most trials.
Methods and results: Of 10,148 patients entered into EVENT, a multicenter registry of unselected patients undergoing attempted PCI from July 2004- December 2007, we studied 2313 patients with advanced CKD (estimated glomerular filtration rate < 60 mL/min based on the Modified Diet in Renal Disease calculation). Patients were stratified into those discharged on statins (n=1837, 79%) or not receiving statins at discharge (n=476, 21%). Patients discharged on statins were more often male and had higher prevalence of hypertension, recent myocardial infarction (MI) and greater use of beta blockers. One year mortality was 5.7% among statin users vs. 8.7% among non-users (HR 0.65; 95% CI: 0.45-0.93). When adjusted for covariates (age, gender, hypertension, recent MI (< 7 days), ejection fraction, NYHA Class and medical therapy differences at discharge (warfarin, beta blockers, ACEi), one year all-cause mortality and composite end point of death/MI/repeat revascularization favored statin (HR 0.55 [0.34, 0.88] and 0.71 [0.51, 0.99] respectively).
Conclusion:The proportion of patients with advanced CKD not discharged on statins post PCI is still high (21%). The current registry analysis showed favorable one year survival in patients discharged on statins following percutaneous coronary intervention in patients with advanced CKD, suggesting the need to investigate broader statin use in this clinical setting.
- © 2011 by American Heart Association, Inc.