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Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study
Open AccessArticle

Effects of Statin Use in Advanced Chronic Kidney Disease Patients

1
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Zhongzheng, Taipei 100, Taiwan
2
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Zhongzheng, Taipei 100, Taiwan
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Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Zhongzheng, Taipei 100, Taiwan
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Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan 736, Taiwan
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Division of Nephrology, Department of Internal Medicine, Saint Mary’s Hospital, Loudong, Yilan 265, Taiwan
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Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli 350, Taiwan
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Cleveland Clinic Lerner College of Medicine and Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44106, USA
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Case Western Reserve University, No. 10900 Euclid Ave., Cleveland, OH 44106, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(9), 285; https://doi.org/10.3390/jcm7090285
Received: 5 August 2018 / Revised: 6 September 2018 / Accepted: 14 September 2018 / Published: 17 September 2018
(This article belongs to the Section Nephrology & Urology)
Although statin treatment is recommended for patients with chronic kidney disease (CKD) stages I–IV, its potential benefits have not been reported in advanced CKD patients. Non-diabetic patients with advanced CKD (pre-dialysis patients, estimated glomerular filtration rate <15 mL/min/1.73 m2) were enrolled from a National Health Insurance Research Database with a population of 23 million. Statin users and non-users were matched using propensity scoring and analyzed using Cox proportional hazards models, taking mortality as a competing risk with subsequent end-stage renal disease (ESRD) and statin doses as time-dependent variables. A total of 2551 statin users and 7653 matched statin non-users were identified from a total 14,452 patients with advanced CKD. Taking mortality as a competing risk, statin use did not increase the risk of new-onset diabetes mellitus (NODM) or decrease the risk of de novo major adverse cardiovascular events (MACE), but reduced all-cause mortality (hazard ratio (HR) = 0.59 [95% CI 0.42–0.84], p = 0.004) and sepsis-related mortality (HR = 0.53 [95% CI 0.32–0.87], p = 0.012). For advanced CKD patients, statin was neither associated with increased risks of developing NODM, nor with decreased risk of de novo MACE occurrence, but with a reduced risk of all-cause mortality, mainly septic deaths. View Full-Text
Keywords: statin; sepsis; chronic kidney disease; diabetes; major adverse cardiovascular events; mortality statin; sepsis; chronic kidney disease; diabetes; major adverse cardiovascular events; mortality
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Huang, T.-M.; Wu, V.-C.; Lin, Y.-F.; Wang, J.-J.; Shiao, C.-C.; Chen, L.; Chueh, S.-C.J.; Chueh, E.; Yang, S.-Y.; Lai, T.-S.; Lin, S.-L.; Chu, T.-S.; Wu, K.-D.; On Behalf of the National Taiwan University Hospital Study Group on Acute Renal Failure (NSARF). Effects of Statin Use in Advanced Chronic Kidney Disease Patients. J. Clin. Med. 2018, 7, 285.

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