ASSOCIATIONS OF STATIN USE WITH REDUCING THE RISK OF ADVERSE CLINICAL OUTCOMES IN A COHORT OF PATIENTS RECEIVING KIDNEY REPLACEMENT THERAPY IN CANADA

Introduction:

Cardiovascular (CV) disease remains the leading cause of morbidity and mortality among people living with kidney disease. While statin therapy has proven benefits in reducing cardiovascular events in the general population and in people with chronic kidney disease, its effectiveness in people undergoing kidney replacement therapy (KRT) remains uncertain. This study aims to evaluate the associations of statin use on major cardiovascular adverse events (MACE) and all-cause mortality in dialysis 

Methods:

This is a retrospective cohort study included individuals aged ≥18 years in Alberta, Canada, who initiated maintenance dialysis between January 1, 2010, and March 31, 2019. Participants were categorized into statin users and non-users. Baseline demographics, including age, sex, and comorbidities were recorded. Patients were categorized into statin users and non-users. The primary outcome was the incidence of composite MACE, consisted of CV death, non-fatal myocardial infarction, non-fatal stroke, or heart failure hospitalization. Secondary outcome was all-cause mortality. 

Results:

The study cohort included 5,733 participants, with 3,949 (68.9%) statin users and 1,784 (31.1%) non-users, having a mean age of 62.4 years and 63% were male. The median follow-up period was 4.1 years, with the majority on hemodialysis (~80%). Common comorbidities included hypertension (88.5%), diabetes (59%), coronary artery disease (41%), and heart failure (38%). Statin use was not associated with a reduced risk of MACE (adjusted hazard ratio (HR) 0.95, 95% CI 0.87-1.04, p=0.256). There was no significant associations between statin use and individual components of MACE: cardiovascular mortality (adjusted HR 1.03, 95% CI 0.87–1.22, p = 0.770), non-fatal myocardial infarction (adjusted HR 1.08, 95% CI 0.83–1.40, p = 0.587), non-fatal stroke (adjusted HR 1.02, 95% CI 0.87–1.20, p = 0.789), and heart failure hospitalization (adjusted HR 0.96, 95% CI 0.87–1.06, p = 0.419). Statin use was associated with a significant reduction in the risk of all-cause mortality (adjusted HR 0.85, 95% CI 0.77-0.92, p<0.001) across all dialysis groups (Table 1).

Conclusions:

Statin use was not associated with a significant reduction in cardiovascular events. However, statin use was significantly associated with a reduced risk of all-cause mortality, suggesting a potential survival benefit for dialysis patients on statin therapy. Further research is needed to elucidate the role of statins in reducing all-cause mortality risk in dialysis.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.