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Effect of statin therapy on cardiovascular and renal outcomes in patients with chronic kidney disease: a systematic review and meta-analysis

Hou, Wanyin, Lv, Jicheng, Perkovic, Vlado, Yang, Lihong, Zhao, Na, Jardine, Meg J., Cass, Alan, Zhang, Hong and Wang, Haiyan (2013). Effect of statin therapy on cardiovascular and renal outcomes in patients with chronic kidney disease: a systematic review and meta-analysis. European Heart Journal,34(24):1807-1817.

Document type: Journal Article

IRMA ID 11035xPUB68
Title Effect of statin therapy on cardiovascular and renal outcomes in patients with chronic kidney disease: a systematic review and meta-analysis
Author Hou, Wanyin
Lv, Jicheng
Perkovic, Vlado
Yang, Lihong
Zhao, Na
Jardine, Meg J.
Cass, Alan
Zhang, Hong
Wang, Haiyan
Journal Name European Heart Journal
Publication Date 2013
Volume Number 34
Issue Number 24
ISSN 0195-668X   (check CDU catalogue open catalogue search in new window)
Start Page 1807
End Page 1817
Total Pages 11
Place of Publication United Kingdom
Publisher Oxford University Press
HERDC Category C1 - Journal Article (DIISR)
Abstract AIMS: The effects of statin therapy in patients with chronic kidney disease (CKD) remain uncertain. We undertook a systematic review and meta-analysis to investigate the effects of statin on major clinical outcomes.

METHODS AND RESULTS:
We systematically searched MEDLINE, Embase, and the Cochrane Library for trials published between 1970 and November 2011. We included prospective, randomized, controlled trials assessing the effects of statins on cardiovascular outcomes in people with kidney disease. Summary estimates of relative risk (RR) reductions were calculated with a random effects model. Thirty-one trials that include at least one event were identified, providing data for 48 429 patients with CKD, including 6690 major cardiovascular events and 6653 deaths. Statin therapy produced a 23% RR reduction (16-30) for major cardiovascular events (P<0.001), an 18% RR reduction (8-27) for coronary events, and 9% (1-16) reduction in cardiovascular or all-cause deaths, but had no significantly effect on stroke (21%, -12 to 44) or no clear effect on kidney failure events (5%, -1 to 10). Adverse events were not significantly increased by statins, including hepatic (RR 1.13, 95% CI 0.92-1.39) or muscular disorders (RR 1.02, 95% CI 0.95-1.09). Subgroup analysis demonstrated the relative effects of statin therapy in CKD were significantly reduced in people with advanced CKD (P < 0.001) but that the absolute risk reductions were comparable.

CONCLUSION:
Statin therapy reduces the risk of major cardiovascular events in patients with chronic kidney disease including those receiving dialysis.
Keywords Cardiovascular events
Chronic kidney disease
Meta-analysis
Statin
DOI http://dx.doi.org/10.1093/eurheartj/eht065   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Thu, 07 Aug 2014, 16:57:19 CST