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Kidney Week

Abstract: PO2374

Hydrophilic vs. Lipophilic Statin Treatments in Patients with CKD After Acute Myocardial Infarction: A Propensity Score-Matched Comparison

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Kim, Jongho, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)
  • Yoon, Soo-Young, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)
  • Kim, Dae Kyu, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)
  • Kang, Shinyeong, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)
  • Kim, Jin sug, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)
  • Jeong, Kyung hwan, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)
  • Hwang, Hyeon Seok, Kyung Hee University Medical Center, Seoul, Korea (the Republic of)
Background

Effect of statin treatment is critical to prevent major adverse cardiac and cerebrovascular events (MACEs) after acute myocardial infarction (AMI). Earlier studies demonstrated that the lipophilicity of statin did not affect prognosis in AMI patients without renal dysfunction. However, the effect of statin lipophilicity was not investigated in chronic kidney disease (CKD) patients.

Methods

We enrolled total 2,020 AMI patients with chronic kidney disease (CKD) from Korea Acute myocardial Infarction Registry between
November 2011 and December 2015. CKD was defined as an eGFR < 60mL/min/1.73 m2 . Patients were divided into two groups based;
hydrophilic (n = 663), lipophilic (n = 1399) statin treatment. The primary endpoint was a combination of 2-year major MACEs after AMI occurrence. Subsequently, a propensity score matched analysis was performed.

Results

The lowest cumulative event rate of MACE (HR 0.71 [95% CI 0.55-0.91], p=0.007), all-cause mortality (HR 0.68 [95% CI 0.50-0.94], p=0.018), recurrent MI (HR 0.42 [95% CI 0.23-0.76], p=0.005) was observed in patients treated with hydrophilic statin in propensity -matched population. In multivariable Cox-regression analysis, compared to patients treated with lipophilic statins, patients treated with hydrophilic statins were associated with lower risk for composite of MACEs (HR 0.70 [95% CI 0.55-0.90], p=0.005), all-cause mortality (HR 0.67 [95% CI 0.49-0.93], p=0.016) and recurrent MI (HR 0.40 [95% CI 0.21-0.73], p=0.003), but not for composite of revascularization, and ischemic stroke.

Conclusion

Hydrophilic statin treatment was significantly better to reduce MACEs and all-cause mortality than lipophilic statins in CKD patients with AMI.