Abstract: TH-PO061
The Impact of Statin Use Before Intensive Care Unit Admission on Patients with AKI After Cardiac Surgery
Session Information
- AKI: Liver Disease, Nephrotoxicity, Novel Therapeutics
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Author
- Liu, Fanna, Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
Background
Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious complication after cardiac surgery. The influence of statin use before surgery on the renal outcome of patients undergoing cardiac surgery is controversial. The purpose of this study was to evaluate the effect of statins on postoperative renal outcomes in patients undergoing cardiac surgery.
Methods
This is a retrospective observational study. We included CSA-AKI patients in the Medical Information Mart for Intensive Care- IV database, and were divided into statin group and non-statin group according to whether they used statins before entering ICU. The main outcome was inpatient mortality and 30-day mortality, and the secondary outcomes were 60-day mortality and 90-day mortality. We used PSM to adjust for confounding factors. The 95% CI and risk ratio were calculated by COX proportional regression model, and the two groups of ICU LOS were compared by multiple linear regression. At the same time, stratified analysis was used to explore whether the relationship between the statins use before ICU and mortality was different in each subgroup, and whether the relationship between different doses of statins and mortality was different. Finally, CSA-AKI patients in the ICU of the First Affiliated Hospital of Jinan University were used as external validation data.
Results
675 pre-ICU statin and 2095 non-statin user were identified. In the COX proportional regression model, pre-ICU statin use was associated with the decreased in-hospital mortality (HR=0.407, 95%CI 0.278-0.595, P<0.001) and 30-day mortality (HR=0.407, 95%CI 0.279-0.595, P<0.001). The survival rate of patients who took statins before entering ICU was significantly higher than that of those who did not use statins at 30 days, 60 days and 90 days. In subgroups of patients with age>65 years (HR=0.373, 95%CI 0.240-0.581, P<0.001), AKI grade I (HR=0.244, 95%CI 0.118-0.428, P<0.001), and without post-myocardial infarction syndrome (HR=0.344, 95%CI 0.218-0.542, P<0.001), statin use can reduce the risk of 30-day mortality in CSA-AKI patients. The in-hospital mortality of CSA-AKI patients treated with atorvastatin≥80mg was significantly reduced (P=0.030).
Conclusion
The pre-ICU statin use was significantly associated with decreased risk in-hospital and 30-day mortality, especially the loading dose of atorvastatin (≥80mg).
Funding
- Other NIH Support