Association between statin therapy and mortality in patients on dialysis after atherosclerotic cardiovascular diseases

Abstract

Statin therapy is essential for secondary prevention in patients with atherosclerotic cardiovascular disease (ASCVD). However, the effects of statin therapy in patients receiving chronic dialysis remain uncertain. We aimed to evaluate the effect of statin therapy on long-term mortality in patients on dialysis after a first-time ASCVD. Patients receiving maintenance dialysis aged ≥ 18 years with a first-time ASCVD event between 2013 and 2018 were included in the Korean National Health Insurance Service database. Associations of statin use with long-term mortality were examined using Cox proportional hazards regression models adjusted for demographics and comorbidities. Among 17,242 patients on dialysis, 9611 (55.7%) were prescribed statins after a first-time ASCVD event. Among statin users, 7376 (76.7%) used moderate-intensity statins. During a mean follow-up of 32.6 ± 20.9 months, statin use was associated with a lower risk of all-cause mortality than statin nonuse after adjusting for confounding factors (hazard ratio [HR]: 0.92; 95% confidence interval [CI] 0.88–0.97; p = 0.0009). Despite a lack of evidence, more than half of patients on dialysis were prescribed statins after an ASCVD event. In patients on dialysis after ASCVD, statin therapy significantly reduced the risk of long-term all-cause mortality.

Correlation between Statin Solubility and Mortality in Patients on Chronic Hemodialysis

“…However, this recommendation was limited to the use of statins for primary prevention. Although the KDIGO guidelines do not provide recommendations for secondary prevention, recent research has suggested that using statins for secondary prevention after cardiovascular events may yield favorable outcomes [36][37][38]. Although we did not include data on the history of statin initiation, considering the limited efficacy of statins for primary prevention and the potentially favorable results for secondary prevention, we believe that many patients in our study may have used statins for secondary prevention.…”