Impact of Statins on Cardiovascular Outcomes in Renal Transplant Recipients: A Systematic Review

Abstract

Patients with chronic kidney disease including renal transplant recipients (RTRs) have a markedly higher prevalence of cardiovascular disease than the general population. Many trials have established the role of statins in the prevention of cardiovascular mortality, not only by decreasing the low density lipoprotein-cholesterol levels but also by their pleotropic effects. These data from the general population may not be applicable to RTRs as these patients have different cardiovascular risk profiles. Till date, only a few prospective, randomized trials have assessed the use of statins in RTRs with regards to cardiovascular outcomes. The Assessment of Lescol in Renal Transplant trial, the largest trial so far, suggested that dyslipidemia management with statins in RTRs is associated with a significant reduction in the incidence of cardiac death and nonfatal myocardial infarction (although differences in the combined primary end point were not statistically significant). The current guidelines from National Kidney Foundation for managing dyslipidemia in RTRs recommend managing all chronic kidney disease patients as a coronary heart disease equivalent. The task group for drafting these guidelines concluded that based on the currently available evidence, additional studies may be needed in RTRs to confirm and extend the results of Assessment of Lescol in Renal Transplant trial.

Effects of Statins on Lipid Profile of Kidney Transplant Recipients: A Meta-Analysis of Randomized Controlled Trials

“…Lipoprotein (a) is a modified form of LDL which regulates inflammation of the endothelium and thrombosis and binds macrophages to promote foam cell formation leading to the deposition of cholesterol in atherosclerotic plaques. In this way, it aggravates tissue injury and increases the risk of atherosclerosis and CVDrelated morbidity and mortality in KTRs [29,30]. Therefore, future investigations are needed to develop interventions that manage lipid abnormalities.…”

Effects of statins on lipid profile of kidney transplant recipients: a meta-analysis of randomized controlled trials

“…Lipoprotein (a) is a modified form of LDL which regulates inflammation of the endothelium, thrombosis and binds macrophages to promote foam cell formation leading to the deposition of cholesterol in atherosclerotic plaques. In this way, it aggravates tissue injury and increases the risk of atherosclerosis and CVD-related morbidity and mortality in KTRs 29, 30. Therefore, future investigations are needed to develop interventions that manage lipid abnormalities.…”