Effects of Statins on Ten-Year Cardiovascular Disease in Kidney Transplant Recipients

Yi-Han Chao ； Jen-Ai Lee ； Wan-Tsui Huang ； Chi-Lan Kao ； Sheng-Jeng Peng

《Acta Nephrologica》 37卷1期 (2023/03) Pp. 14-33

https://doi.org/10.6221/AN.202303_37(1).0003

摘要

BACKGROUND: Statins therapy is associated with a reduced risk of cardiovascular disease in the general population. However, the benefits of statins in kidney transplant (KT) recipients are not established. We aimed to investigate the effects of statins on 10-year cardiovascular risk in KT recipients, and to explore other risk factors. METHODS: A retrospective cohort study was performed by using the electronic medical record database of a medical center in Taiwan. We selected all patients who had a diagnosis code of KT from January 1, 2007 to September 1, 2018. The primary endpoint was the incidence of a major cardiovascular event (MACE) during 10 years, composite of ischemic heart disease, cerebrovascular event, or cardiac death. Survival analysis was performed by the Kaplan-Meier method and Cox proportional hazards regression. RESULTS: A total of 78 patients were included and followed for a median of 7.89 years. Compared to non-statin group (n = 55), statin group (n = 23) did not have a significant lower risk of MACE (crude hazard ratio [HR], 1.43; 95% confidence interval [CI], 0.53-3.88; Model 1, HR, 1.62; 95% CI, 0.55-4.76; Model 2, HR, 1.62; 95% CI, 0.56 to -4.68; Model 3, HR, 1.49; 95% CI, 0.55-4.06). The risk factors for MACE were age (HR, 1.11; 95% CI, 1.05-1.18), male gender (HR, 3.49; 95% CI, 1.23-9.94), diabetes mellitus (HR, 3.15; 95% CI, 1.18-8.42), triglycerides (HR, 1.01; 95% CI, 1.00-1.02) and serum phosphorus (HR, 2.51; 95% CI, 1.16-5.43). CONCLUSION: Statins may not reduce the risk of MACE in KT recipients. In addition to traditional risk factors, the level of serum phosphorus may also associate with MACE.

關鍵字

cerebrovascular event ； ischemic heart disease ； kidney transplant ； major cardiovascular event ； statins