Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports Pub Date : 2024-10-01 DOI:10.1016/j.ekir.2024.07.033

Jihyun Yang , Kyu-Beck Lee , Hyang Kim , Soo Wan Kim , Yeong Hoon Kim , Su Ah Sung , Jayoun Kim , Kook-Hwan Oh , Ji Yong Jung , Young Youl Hyun

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Abstract

Introduction

Statin treatment can reduce the risk of cardiovascular disease (CVD). Paradoxically, previous studies have shown that the use of statin is associated with the progression coronary artery calcification (CAC), a well-known predictor of CVD, in individuals with preserved renal function or in patients on dialysis. However, little is known about the association in patients with predialysis chronic kidney disease (CKD). The aim of this study was to characterize the relationship between statin use and progression of CAC in a CKD cohort of Korean adults.

Methods

We analyzed 1177 participants registered in the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD) cohort. Coronary artery calcium score (CACS) was assessed using cardiac computed tomography at baseline and 4 years after enrollment. CAC progression was defined using the Sevrukov method. Statin users were defined as those who used statins for 50% or more of the follow-up period.

Results

The median (interquartile range) of CACS was 0 (0–30.33), and 318 (44.2%) participants had CACS above 0 at baseline. There were 447 (38.0%) statin users and 730 (62.0%) statin nonusers. After 4 years, 374 patients (52.0%) demonstrated CAC progression, which was significantly more frequent in statin users than in statin nonusers (218 [58.3%] vs. 156 [41.7%], P < 0.001). The multivariate-adjusted odds ratio for CAC progression in statin users compared to statin nonusers was 1.78 (1.26–2.50).

Conclusion

Statin use, significantly and independently, is associated with CAC progression in Korean patients with predialysis CKD. Further research is warranted to verify the prognosis of statin-related CAC progression.

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他汀类药物的使用与慢性肾脏病患者冠状动脉钙化的进展：KNOW-CKD 研究的发现

他汀类药物治疗可降低罹患心血管疾病（CVD）的风险。矛盾的是，先前的研究表明，在肾功能保留或透析患者中，他汀类药物的使用与冠状动脉钙化（CAC）的进展有关，而CAC是众所周知的心血管疾病的预测指标。然而，人们对透析前慢性肾脏病（CKD）患者的相关性知之甚少。本研究旨在描述他汀类药物的使用与韩国成年人 CKD 队列中 CAC 进展之间的关系。我们分析了在韩国慢性肾病患者结局队列研究（KNOW-CKD）队列中登记的 1177 名参与者。在基线和入组 4 年后，使用心脏计算机断层扫描评估冠状动脉钙化评分（CACS）。CAC进展采用Sevrukov法进行定义。他汀类药物使用者被定义为在随访期间使用他汀类药物达50%或以上者。CACS的中位数（四分位数间距）为0（0-30.33），318名参与者（44.2%）在基线时CACS高于0。他汀类药物使用者为 447 人（38.0%），非使用者为 730 人（62.0%）。4 年后，374 名患者（52.0%）出现了 CAC 进展，他汀类药物使用者的 CAC 进展频率明显高于他汀类药物非使用者（218 [58.3%] 对 156 [41.7%]，< 0.001）。与他汀类药物非使用者相比，他汀类药物使用者CAC进展的多变量调整赔率为1.78（1.26-2.50）。他汀类药物的使用与韩国透析前慢性肾脏病患者的 CAC 进展密切相关。需要进一步研究来验证他汀类药物相关 CAC 进展的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney International Reports Medicine-Nephrology

CiteScore

7.70

自引率

3.30%

发文量

1578

审稿时长

8 weeks

期刊介绍： Kidney International Reports, an official journal of the International Society of Nephrology, is a peer-reviewed, open access journal devoted to the publication of leading research and developments related to kidney disease. With the primary aim of contributing to improved care of patients with kidney disease, the journal will publish original clinical and select translational articles and educational content related to the pathogenesis, evaluation and management of acute and chronic kidney disease, end stage renal disease (including transplantation), acid-base, fluid and electrolyte disturbances and hypertension. Of particular interest are submissions related to clinical trials, epidemiology, systematic reviews (including meta-analyses) and outcomes research. The journal will also provide a platform for wider dissemination of national and regional guidelines as well as consensus meeting reports.