Pleiotropic Effects of Statins May Improve Outcomes in Atherosclerotic Renovascular Disease

Abstract

Statin therapy was associated with lesser rate of progression of renal insufficiency (with 7.4% of S patients reaching renal end points vs. 38.9% of NS patients) and lower overall mortality (5.9 % in S vs. 36.1% in NS patients), P < 0.001 for both. Although both groups received what was deemed optimal therapy, they did have other differences that may have affected the outcomes (a limitation addressed by Cox multiple regression analysis). These results suggest the need for prospective randomized controlled studies in ARD patients in order to explore potential benefits of statins that may not be attributable solely to lipid lowering.

Statin Therapy in ARAS: Beyond Cholesterol Lowering

“…6 In this 11-year long retrospective observational study, the authors confirm former reports identifying renal dysfunction due to ARAS as a predictor of cardiovascular mortality. As a novel finding, Silva et al identified the use of statins as beneficial regarding renal function preservation (progression of renal insufficiency: 7.4% of S patients (patients who received statin therapy) vs. 38.9% of NS patients (patients who had no statin)) and patient survival (overall mortality: 5.9% in S patients vs. 36.1% in NS patients).…”

Diagnosis and treatment of renal artery stenosis

“…statins are safe and effective in preventing cardiovascular events in patients with chronic kidney disease before dialysis, including patients with atherosclerotic ras. 16,34,35 renin-angiotensin antagonists are more effective than other antihypertensive agents in reducing blood pressure and preventing death in animal models of ras. 36 with the exception of one inconclusive trial that included only six patients 37 and another that was poorly designed, 38 no randomized, controlled trials have been carried out to compare standard treatment with renin-angiotensin antagonists in patients with ras.…”

When statin therapy stops: implications for the patient

“…Statins (HMG CoA reductase inhibitors) have well established beneficial effects in reducing cardiovascular risk, and statin treatment is clearly indicated in CVD guidelines [1-3]. More specifically, statins significantly decrease low-density lipoprotein cholesterol (LDL-C) and beneficially affect outcomes (including cardiovascular mortality, all-cause mortality, cardiovascular events, and revascularization) in different patient groups; these effects have been reviewed extensively recently [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. However, patients do not always adhere to their medication, and statin compliance is low in clinical practice.…”