STATIN THERAPY AND CORTICOSTEROID THERAPY IN KIDNEY TRANSPLANTATION: EFFECTS ON CARDIOVASCULAR EVENT AND DEATH RATES (original) (raw)

Transplantation, 2008

Abstract

ABSTRACT Purpose: Statin therapy has previously been shown to reduce acute rejection (AR) risk in cardiac transplant (txp). Moreover, statin therapy reduces risk for cardiovascular events (CVE) in the general population. The purpose of this study was to evaluate statin therapy on AR, CVE, and patient (pt) survival in kidney txp recipients. Methods: Pts were categorized by presence or absence of statin therapy post-txp. Univariate analysis (UVA) and multivariate analysis (MVA) were conducted by stepwise logistic regression (STATA v9.2) to determine significant risk factors for AR, CVE, and pt survival. Kaplan Meier analysis was conducted for pt survival and CVE rates. Results: 638 renal txp pts were analyzed from 1997-2007 (46% statin v. 54% no statin). Baseline characteristics and AR rates were similar between groups. Statin therapy post-txp was associated with increased pt survival (95% v. 90%, p< 0.02) and decreased incidence of CVE (15% v. 21%, p < 0.05). Individual factors for CVE evaluated by UVA and found to be insignificant included: current PRA > 25%, HDL < 40 mg/dL, African American recipient race, age, gender. Significant factors for CVE on UVA included: pre-txp diabetes (DM), statin therapy, repeat txp, deceased donor (DD), corticosteroid therapy (CS), and DR mismatch > 0. Significant factors on final MVA included: DM (OR 3.2, CI 2.0-4.9) and CS (OR 3.2, CI 2.0-4.9). Significant factors for pt survival on UVA included: pre-txp DM, statin therapy, DD, CS, delayed graft function, and DR mismatch > 0. Significant factors on final MVA included: DM, males, and CS. Statin therapy approaches significance in the MVA for decreasing risk of CVE (p=0.07) and death rates (p=0.08). Conclusions: This analysis indicates that CS increases CVE and death rates. Statin therapy offers a means for reducing cardiovascular risk in patients receiving CS. * * * *

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