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他汀类药物治疗对合并冠状动脉疾病的慢性肾脏病患者的影响。

Effects of statin therapy on chronic kidney disease patients with coronary artery disease.

机构信息

Department of Clinical Laboratory Medicine, First People's Hospital of Wujiang District, Nantong University, Suzhou, China.

Department of Internal Medicine, First People's Hospital of Wujiang District, Nantong University, Suzhou, China.

出版信息

Lipids Health Dis. 2018 Apr 17;17(1):84. doi: 10.1186/s12944-018-0742-4.

Abstract

BACKGROUND

Long-term persistence of statin therapy provided an ongoing reduction in mortality among patients with and without a known history of CVD, and renoprotective effect on CKD patients. Until now, very few reports are available from China to address the effects of statin therapy in CKD + CAD patients.

METHODS

We compared the effects of long-term statin therapy (follow-up time 4 years) in terms of cardiovascular events, all-cause death, and cardiac death among 254 CKD patients with or without CAD.

RESULTS

Long-term statin therapy was much more effective in the CKD + CAD patients compared with CKD patients. In the CAD + CKD patients, long-term statins showed a 22.2% reduction in the CVs rate (P = 0.012). With regard to the all-cause and cardiac deaths, long-term statins had significant treatment effects on the CAD + CKD patients (reduction of about 28.1% in mortality rates, P < 0.001). In contrast, long-term statin therapy exerted no significant influence on the clinical outcomes of the CKD-only patients.

CONCLUSION

Long-term statin therapy more dramatically reduced the CVs and mortality rates of the CKD patients with concomitant CAD. In contrast, CKD-only patients had a good prognosis and did not appear to require statin treatment.

摘要

背景

长期使用他汀类药物治疗可降低有或无已知 CVD 病史患者的死亡率,并对 CKD 患者有肾脏保护作用。到目前为止,来自中国的关于他汀类药物治疗在 CKD+CAD 患者中的效果的报告非常少。

方法

我们比较了 254 例有或无 CAD 的 CKD 患者长期他汀类药物治疗(随访时间 4 年)在心血管事件、全因死亡和心脏死亡方面的效果。

结果

与 CKD 患者相比,长期他汀类药物治疗在 CAD+CKD 患者中效果更好。在 CAD+CKD 患者中,长期他汀类药物治疗可使 CVs 发生率降低 22.2%(P=0.012)。对于全因死亡和心脏死亡,长期他汀类药物治疗对 CAD+CKD 患者有显著的治疗效果(死亡率降低约 28.1%,P<0.001)。相比之下,长期他汀类药物治疗对仅 CKD 患者的临床结局没有显著影响。

结论

长期他汀类药物治疗可更显著降低合并 CAD 的 CKD 患者的 CVs 和死亡率。相比之下,仅 CKD 患者的预后良好,似乎不需要他汀类药物治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3d2/5902851/5ad44039ee18/12944_2018_742_Fig1_HTML.jpg

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