Ma Huan, Liu Yong, Xie Haixia, Zhang Guolin, Zhan Huimin, Liu Zhi, Wang Ping, Geng Qingshan, Guo Lan
Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital Guangdong Academy of Medical Sciences, Guangdong, China.
Medicine (Baltimore). 2017 Aug;96(32):e7351. doi: 10.1097/MD.0000000000007351.
Some statins, such as atorvastatin, have proven renoprotective effects. The comparative renoprotective potential of simvastatin is less clear. This study aimed to compare the renoprotective effects of simvastatin with atorvastatin in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This observational study examined the medical records of 271 patients who were treated at the Guangdong Cardiovascular Institute from April 2004 to February 2008. Patients had received either 40 mg simvastatin (n = 128) or 20 mg atorvastatin (n = 143), daily, for a period of at least 6 months following PCI. Declined renal function (DRF) was defined at the occurrence of chronic kidney disease (CKD) or elevated CKD stages at 6-months post-PCI. Results showed that the incidence of DRF was similar among patients taking simvastatin or atorvastatin (25.00% vs 26.57%, respectively). Kaplan-Meier survival analysis showed that patients who developed DRF had a higher incidence of mortality and major adverse cardiovascular events (MACEs) than those without DRF (17.41% vs 28.57%, P = .0308). Multivariate logistic regression analysis identified diabetes and baseline estimated glomerular filtration rate as independent risk factors for DRF. Collectively, our results indicate that simvastatin has comparable renoprotective effects to atorvastatin in ACS patients undergoing PCI. Further studies are warranted to confirm the comparative renoprotective effects of statins.
一些他汀类药物,如阿托伐他汀,已被证明具有肾脏保护作用。辛伐他汀的相对肾脏保护潜力尚不太明确。本研究旨在比较辛伐他汀与阿托伐他汀在接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者中的肾脏保护作用。这项观察性研究检查了2004年4月至2008年2月在广东省心血管病研究所接受治疗的271例患者的病历。患者在PCI术后每天接受40mg辛伐他汀(n = 128)或20mg阿托伐他汀(n = 143)治疗,为期至少6个月。肾功能下降(DRF)定义为PCI术后6个月时慢性肾脏病(CKD)的发生或CKD分期升高。结果显示,服用辛伐他汀或阿托伐他汀的患者中DRF的发生率相似(分别为25.00%和26.57%)。Kaplan-Meier生存分析显示,发生DRF的患者比未发生DRF的患者有更高的死亡率和主要不良心血管事件(MACE)发生率(17.41%对28.57%,P = 0.0308)。多因素逻辑回归分析确定糖尿病和基线估计肾小球滤过率是DRF的独立危险因素。总体而言,我们的结果表明,在接受PCI的ACS患者中,辛伐他汀具有与阿托伐他汀相当的肾脏保护作用。有必要进行进一步的研究以证实他汀类药物的相对肾脏保护作用。