Division of Cardiology, Department of internal medicine, CHA University, Seongnam, South Korea.
Division of Nephrology, Department of Internal Medicine, CHA University, Seongnam, South Korea.
Sci Rep. 2018 Jun 26;8(1):9692. doi: 10.1038/s41598-018-27941-w.
The cardiovascular diseases are the leading cause of mortality in end-stage renal disease (ESRD) patients. However, roles of statins are still controversial in dialysis-dependent ESRD patients regardless of having proven coronary artery occlusive disease. The aim of this study was to examine the benefit of statin following percutaneous coronary intervention (PCI) in ESRD patients who have proven coronary artery occlusive disease. This study was based on the National Health Insurance Service-National Sample Cohort in South Korea. We included 150 ESRD patients on chronic hemodialysis who underwent PCI with stenting between 2002 and 2013. The primary outcome was a composite of myocardial infarction, stroke, and all-cause mortality. Multivariate time-dependent Cox regression analysis were performed, and statin therapy after PCI was treated as a time-dependent variable. During 3.15 ± 2.71 (mean ± standard deviation) years of follow-up, there were 82 patients with primary outcome. The adjusted hazard ratio for statin use was 0.54 [0.33-0.90] compared to no statin use. This study showed that statin has significant benefit on reducing adverse events risk in dialysis-dependent ESRD patients after PCI.
心血管疾病是终末期肾病（ESRD）患者死亡的主要原因。然而，他汀类药物在依赖透析的 ESRD 患者中的作用仍存在争议，无论其是否患有已证实的冠状动脉阻塞性疾病。本研究旨在研究在患有已证实的冠状动脉阻塞性疾病的 ESRD 患者中，经皮冠状动脉介入治疗（PCI）后使用他汀类药物的益处。本研究基于韩国国家健康保险服务-国家样本队列。我们纳入了 2002 年至 2013 年间接受 PCI 加支架置入术的 150 名慢性血液透析的 ESRD 患者。主要结局是心肌梗死、卒中和全因死亡率的复合结局。进行了多变量时间依赖性 Cox 回归分析，将 PCI 后使用他汀类药物作为时间依赖性变量。在 3.15±2.71（平均值±标准差）年的随访期间，有 82 名患者出现主要结局。与未使用他汀类药物相比，使用他汀类药物的调整后危害比为 0.54 [0.33-0.90]。本研究表明，他汀类药物在降低依赖透析的 ESRD 患者 PCI 后不良事件风险方面具有显著益处。
