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Kidney Week

Abstract: PO2493

Racial Disparities in Receipt of Medications for Secondary Prevention of Cardiovascular Disease in Kidney Transplant Recipients in the FAVORIT Trial

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Fallahzadeh Abarghouei, Mohammad Kazem, Division of Nephrology, UCSF, San Francisco, California, United States
  • Ku, Elaine, Division of Nephrology, UCSF, San Francisco, California, United States
  • Chu, Chi D., Division of Nephrology, UCSF, San Francisco, California, United States
  • McCulloch, Charles E., Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, United States
  • Tuot, Delphine S., Division of Nephrology, UCSF, San Francisco, California, United States
Background

Cardiovascular disease (CVD) is the most common cause of death with a functioning graft in kidney transplant recipients. Black patients have been shown to have higher prevalence of cardiovascular (CV) risk factors and less intensive risk factor modification. We evaluated racial disparities in receipt of HMG-Co-A reductase inhibitors (statins) and aspirin for secondary prevention of CVD in kidney transplant patients in the Folic Acid for Vascular Outcome Reduction in Transplantation Trial (FAVORIT) trial.

Methods

FAVORIT was a multicenter international trial of vitamin therapy to lower homocysteine levels and improve CV outcomes in kidney transplant patients. We identified FAVORIT trial participants from US and Canada who had a self-reported history of established CVD at baseline and/or developed a CVD event during the study. We used parametric interval-censored survival models to evaluate the effect of race on self-reported receipt of statins and aspirin for secondary CV prevention, adjusting for age, gender, ethnicity, and country of enrollment. In addition, we controlled for baseline cyclosporin use in the model assessing statin use and graft vintage in the model assessing aspirin use.

Results

Of the 4110 kidney transplant patients enrolled in FAVORIT, 978 met the inclusion criteria (78% White, 17% Black, 6% Other race). Mean age was 55.7±8.9 years, 70% were male, and mean graft vintage was 5.4±4.7 years. Black race was independently associated with lower hazard of receiving statin for secondary CVD prevention compared with White race (aHR=0.77, 95% CI: 0.60-0.97). There was no significant difference in aspirin use by Black race compared with White race (aHR=0.86, 95% CI: 0.67-1.09).

Conclusion

Findings from a large multicenter trial showed that Black race was associated with lower hazard of receiving statins for secondary CVD prevention. Underutilization of statins represents a potential target to improve CVD preventive care in Black kidney transplant recipients.

Funding

  • NIDDK Support