Key result
Moderate-to-high intensity statins linked to ~24% lower mortality in dialysis patients post-MI.
Why the study?
The effect of moderate to high intensity statin therapy on mortality and cardiovascular outcomes in dialysis patients after acute myocardial infarction was unclear.
Does moderate to high intensity statin therapy reduce all-cause mortality and cardiovascular outcomes in dialysis patients after acute myocardial infarction?
Cohort (n=2,578)
Yes
Does moderate to high intensity statin therapy reduce all-cause mortality and cardiovascular outcomes in dialysis patients after acute myocardial infarction?
Hazard Ratio: 0.76 (95% CI 0.67–0.88)
Absolute Event Rate: 48% vs 55.1%
Moderate to high intensity statin therapy is associated with reduced all-cause mortality in dialysis patients following an acute myocardial infarction, particularly in those presenting with shock.
May support statin consideration post-MI in dialysis; hypothesis-generating and requires RCT confirmation.
BACKGROUND AND AIMS: Statin is not beneficial for dialysis patients but moderate to high intensity statin is beneficial for patients after acute myocardial infarction (MI). The aim of this study was to evaluate the effect of moderate to high intensity statin on mortality, cardiovascular outcomes in dialysis patients after acute MI. METHODS: Data on dialysis patients were retrieved from the National Health Insurance Research Database in Taiwan. Dialysis patients admitted for MI were selected and divided into two groups according to statin prescription or not after MI. All-cause mortality and cardiovascular outcomes after a 4-year follow-up were analyzed after propensity score matching (PSM). RESULTS: We identified 790 patients who received moderate to high intensity statin therapy and 1788 patients who did not receive any statins after acute MI and clinical outcomes were analyzed after 1:1 PSM. The benefit of statin on mortality therapy appeared from 1 year to the end of the 4-year follow-up period after hospitalization (statin group versus non-statin group: 22.9% vs. 31.1% at 1 year (HR: 0.70; 95% CI: 0.58-0.85); 48.0% vs. 55.1% at the end of the 4 years (HR: 0.76; 95% CI: 0.67-0.88)). In addition, the impact of statin therapy was stronger in patients with shock at admission (p = 0.035). There were no differences in any individual cardiovascular outcome or adverse event. CONCLUSIONS: Moderate to high intensity statin therapy might lower all-cause mortality in dialysis patients after acute MI, especially those with shock, but not influence cardiovascular outcomes and any adverse events.
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Chung et al. (2017) conducted a cohort in Dialysis patients after acute myocardial infarction (n=2,578). Moderate to high intensity statin therapy vs. No statin therapy was evaluated on All-cause mortality at 4 years (HR 0.76, 95% CI 0.67-0.88). Moderate to high intensity statin therapy was associated with lower 4-year all-cause mortality compared to no statin in dialysis patients after acute MI (48.0% vs 55.1%; HR 0.76, 95% CI 0.67-0.88).
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