Statin therapy ineffective in patients with advanced kidney disease

Patients with advanced renal dysfunction received no significant benefit from statin therapy following acute MI in a study of 861 individuals.

A South Korean research team identified patients with advanced renal dysfunction who underwent PCI after acute MI between November 2005 and July 2012. The study population, also based in South Korea, was 55.4 percent men and had a mean age of 69.4.

Patients were divided into a statin group (537 patients) and a no-statin group (324). Researchers investigated the one-year all-cause mortality and major adverse cardiac events (MACEs) of both groups, defined as cardiac death, MI, repeated PCI or coronary artery bypass grafting (CABG). They published their results online in PLOS ONE.

No significant differences were observed in all-cause mortality or rates of recurrent MI, PCI or CABG between the two groups. The cardiac death rate was 10.8 percent in the statin group versus 17 percent in the no-statin group, but that gap closed once propensity score-matching was applied.

After adjustment, left ventricular ejection fraction (LVEF) was the only factor independently associated with MACEs. Higher LVEF demonstrated a protective effect on MACEs, the research showed.

“Statins were not conclusively shown to demonstrate beneficial effects on clinical outcomes, and our finding was similar to results obtained from previous studies,” wrote the researchers, led by Jin Sug Kim, Weon Kim and Ji Yoon Park, all with Kyung Hee University School of Medicine in Seoul, South Korea.

“Statins might be ineffective in patients with advanced CKD (chronic kidney disease) but might have some role in patients with mild CKD. A possible explanation could be that unconventional contributory risk factors worsen as the disease progresses.”

To build on this research, the authors recommended future studies with longer follow-up periods and a focus on improving clinical outcomes.