ANTIPLATLET AND STATIN THERAPY FOR THE PRIMARY PREVENTION OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE IN HEMODIALYSIS PATIENTS: A CASE-CONTROL STUDY

8 Feb 2025 12 a.m. 12 a.m.

WCN25-AB-1139, Poster Board= SAT-281

Introduction:

Despite the well-established benefits of antiplatelets and statins in the secondary prevention of coronary artery disease (CAD), the role of antiplatelets, and statins in hemodialysis patients, in the primary prevention of CAD is still conflicting with some studies even demonstrating a harmful effect of the treatments.

Methods:

A retrospective study was conducted at a medical school hospital in Thailand. Electronic medical record data of hemodialysis patients without preexisting CAD undergoing coronary angiogram (CAG) between January 2017 and March 2023 was systematically reviewed. Those with and without significant CAD, defined as >70% stenosis of at least 1 major branch of the coronary arteries or >50% of the left main coronary artery, were compared regarding the prescriptions of antiplatelets and statins.

Results:

Ninety-five patients, with 44% female and mean age of 63.8±14.1 years, were included in the analysis. Upon univariate analysis, only age and diabetes mellitus significantly associated with the presence of CAD with odd ratios (OR) of 1.040 per 1 year (95%CI 1.007-1.073) and 5.429 (95%CI 2.110-13.971), respectively. Prescription of antiplatelets and statins did not significantly associate with CAD. These findings persisted in multivariate analysis. In subgroup analyses, antiplatelet therapy in non-diabetic patients significantly correlated with the presence of CAD (OR 4.000, 95%CI 1.193-13.410).

Table 1. Odds Ratio for CAD in Overall Cohort (Logistic Regression)

Conclusions:

Pathogenesis of CAD in hemodialysis patients might include non-traditional pathways that could not be predicted or reversed with conventional therapy for CAD. Primary prevention in this group with antiplatelets and statins did not correlate with a lower incidence of CAD. Further studies on this topic are necessary.

This abstract was also submitted for the Nephrology Society of Thailand Annual Meeting 2024.

I have no potential conflict of interest to disclose.

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