Frasco Peter E, Rosenfeld David M, Jadlowiec Caroline C, Zhang Nan, Heilman Raymond L, Bauer Isabel L, Alvord Jeremy, Poterack Karl A
Department of Anesthesiology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Department of Transplant Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Clin Transplant. 2022 Dec;36(12):e14805. doi: 10.1111/ctr.14805. Epub 2022 Sep 20.
The pleiotropic effects of statin therapy on inflammation and coagulation may reduce the risk of venous thromboembolism. This study evaluated whether statin therapy is associated with decreased venous thromboembolic (VTE) events following kidney transplantation.
We performed a retrospective analysis of all primary kidney transplants performed between January 2014 and December 2019 at Mayo Clinic Arizona. Patients were divided into two groups depending on sustained statin therapy during the first year following transplantation. Recipient and donor clinical and demographic data were collected. The primary outcome was admission for symptomatic VTE events (deep vein thrombosis [DVT] or pulmonary embolism [PE]).
Sustained statin therapy in the first year following transplant was observed in 16.1% (n = 223) of 1384 kidney transplants. The overall incidence of VTE events in the year following kidney transplant was 3.8%. VTE occurred in 4.1% of recipients treated with statins and 3.8% of the controls - (hazard ratio [HR] .92, 95% confidence interval [95% CI] .39, 2.21, p = .86). However, there were significant differences between the groups in terms of age, sex, race/ethnicity, body mass index, indication for transplant, diagnosis of diabetes and discharge antiplatelet or anticoagulant therapy. Following sensitivity analysis in which cohort matching was performed to account for these differences, there was no difference in VTE event-free survival (HR .89, 95% CI .41, 1.96, p = .78) or overall survival (HR .54, 95% CI .15, 1.94, p = .35) between patients treated with statins compared to controls.
Statin therapy in the year following successful kidney transplant was not associated with a reduction in risk of VTE.
他汀类药物治疗对炎症和凝血的多效性作用可能会降低静脉血栓栓塞的风险。本研究评估了他汀类药物治疗是否与肾移植后静脉血栓栓塞（VTE）事件减少相关。
我们对2014年1月至2019年12月在亚利桑那州梅奥诊所进行的所有原发性肾移植进行了回顾性分析。根据移植后第一年是否持续使用他汀类药物治疗，将患者分为两组。收集受者和供者的临床及人口统计学数据。主要结局是因有症状的VTE事件（深静脉血栓形成[DVT]或肺栓塞[PE]）入院。
在1384例肾移植中，16.1%（n = 223）的患者在移植后第一年持续接受他汀类药物治疗。肾移植后一年VTE事件的总体发生率为3.8%。接受他汀类药物治疗的受者中有4.1%发生VTE，对照组中有3.8%发生VTE - （风险比[HR] 0.92，95%置信区间[95%CI] 0.39，2.21，p = 0.86）。然而，两组在年龄、性别、种族/民族、体重指数、移植指征、糖尿病诊断以及出院时的抗血小板或抗凝治疗方面存在显著差异。在进行队列匹配以考虑这些差异的敏感性分析后，与对照组相比，接受他汀类药物治疗的患者在无VTE事件生存（HR 0.89，95%CI 0.41，1.96，p = 0.78）或总生存（HR 0.54，95%CI 0.15，1.94，p = 0.35）方面没有差异。
成功肾移植后一年内使用他汀类药物治疗与VTE风险降低无关。
