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Abstract: TH-PO0495

Association of Statin Therapy with Adverse Clinical Outcomes Among Patients on Dialysis: A Province-Wide Retrospective Cohort Study

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Ibrahim, Halimat Oluwakemi, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Tungsanga, Somkanya, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Canada
  • Ye, Feng, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Ehindero, Toluwatise, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Lategan, Irizelle, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Okpechi, Ikechi G., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
  • Bello, Aminu K., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
Background

Although statins reduce cardiovascular (CV) events in non-dialysis chronic kidney disease, their benefit in dialysis patients is unclear. We evaluated the association between statin use, major cardiovascular events (MACE), and all-cause mortality in chronic dialysis patients in Alberta, Canada

Methods

A retrospective study of 6,453 adults starting dialysis (2010–2019) that included statin users (n=4,483) and non-users (n=1,970). Primary outcome was a composite MACE (CV death, non-fatal myocardial infarction (MI), non-fatal stroke, or heart failure (HF) hospitalization); secondary outcome was all-cause mortality. Analyses were adjusted for demographics, clinical characteristics, and medications

Results

Over a median 3.6-year follow-up, participants (median age 62.2 years, 37.6% male) were mostly on hemodialysis (71.3%) with common comorbidities like hypertension (88.6%), diabetes (58.1%), coronary artery disease (41.3%), and HF (37.1%). Statin use was not associated with reduced MACE risk (adjusted hazard ratio [aHR] 0.98, 95% CI: 0.89–1.09; p=0.760), nor its individual components. However, it was significantly associated with lower all-cause mortality (aHR 0.84, 95% CI: 0.77–0.91; p<0.001), with benefit greatest in those aged 50–65 years (aHR 0.67). Continuous and new statin users had lower mortality (aHRs 0.69 and 0.81), while prior users (statin use discontinued after dialysis initiation) showed increased risk (aHR 1.98)

Conclusion

In this province-wide dialysis cohort, statin use was not associated with a reduction in MACE but linked to a reduced risk of all-cause mortality, suggesting a potential survival benefit warranting further studies

Association between statin use and the risk of major adverse cardiovascular events (MACE) and their components, all-cause mortality, and all-cause hospitalization.

Funding

  • Private Foundation Support

Digital Object Identifier (DOI)