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  • Impact of statin on long-term outcome among patients with end-stage renal disease with acute myocardial infarction (AMI): a nationwide case–control study

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Original research
Impact of statin on long-term outcome among patients with end-stage renal disease with acute myocardial infarction (AMI): a nationwide case–control study
  1. Feng-You Kuo1,2 the whole study team,
  2. Wei-Chun Huang3,
  3. Pei-Ling Tang3,
  4. Chin-Chang Cheng3,
  5. Cheng-Hung Chiang3,
  6. Hsiao-Chin Lin3,
  7. Tzu-Jung Chuang3,
  8. Shue-Ren Wann3,
  9. Guang-Yuan Mar3,
  10. Chun-Peng Liu3,
  11. Juei-Tang Cheng2,
  12. Ming-Chang Wu2
  1. 1 Cardiovascular Center, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
  2. 2 Department of Food Science, National Pingtung University of Science and Technology, Pingtung, Taiwan
  3. 3 Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
  1. Correspondence to Professor Ming-Chang Wu, Department of Food Science, National Pingtung University of Science and Technology, Pingtung, Taiwan; mcwu{at}mail.npust.edu.tw; Professor Chun-Peng Liu; cpliu{at}vghks.gov.tw

Abstract

Background Use of statin has been associated with reduced risk of cardiovascular diseases events and mortality. However, in patients with end-stage renal disease (ESRD), the protective effects of statin are controversial. To evaluate the impact of chronic statin use on clinical outcomes of patients with acute myocardial infarction (AMI) with ESRD.

Methods We enrolled 8056 patients with ESRD who were initially diagnosed and admitted for first AMI from Taiwan’s National Health Insurance Research Database. Of which, 2134 patients underwent statin therapy. We randomly selected and use age, sex, hypertension, diabetes mellitus (DM), peripheral vascular diseases (PVD), heart failure (HF), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease, matched with the study group as controls (non-stain user). We compared the effects of statin use in term of all-cause death among patients with AMI with ESRD.

Results Statin use resulted in a significantly higher survival rate in patients ith AMI with ESRD compared with non-statin users. After adjusted the comorbidities the male patients and patients with DM, PVD, HF and CVA had lower long-term survival rate (all p<0.001). Patients who underwent percutaneous coronary intervention (p<0.001), ACE inhibitors/angiotensin II receptor blockers (p<0.001), β receptor blockers (p<0.001) and statin therapy (p=0.007) had better long-term survival rate. Patients with AMI with ESRD on statin therapy exhibited a significantly lower risk of mortality compared with non-statin users (p<0.0001).

Conclusion Among patients with ESRD with AMI, statin therapy was associated with reduced all-cause mortality.

  • nephrology
  • clinical audit

Data availability statement

Data are available on reasonable request. We enrolled 8056 patients with ESRD who were initially diagnosed and admitted for first AMI from Taiwan’s National Health Insurance Research Database (NHIRD). Of which, 2134 patients underwent statin therapy. We randomly selected and use age, sex, hypertension (HTN), diabetes mellitus (DM), peripheral vascular diseases (PVD), heart failure (HF), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease (COPD), matched with the study group as controls (non-stain user). We compared the effects of statin use in term of all-cause death among patients with AMI with ESRD.

http://dx.doi.org/10.1136/postgradmedj-2019-137292

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    Data availability statement

    Data are available on reasonable request. We enrolled 8056 patients with ESRD who were initially diagnosed and admitted for first AMI from Taiwan’s National Health Insurance Research Database (NHIRD). Of which, 2134 patients underwent statin therapy. We randomly selected and use age, sex, hypertension (HTN), diabetes mellitus (DM), peripheral vascular diseases (PVD), heart failure (HF), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease (COPD), matched with the study group as controls (non-stain user). We compared the effects of statin use in term of all-cause death among patients with AMI with ESRD.

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    Footnotes

    • C-PL and M-CW contributed equally.

    • Contributors Study concept/design: F-YK and W-CH; data collection and analysis: C-HC, CKT, J-TC, IJT, IKW, CHT and CYH; data interpretation: C-HC, CKT, LML, JTL, JHY, CCL, YFS, FCY and CLT; manuscript writing: C-HC, CKT and JTL. All authors have given their final approval of the version to be published.

    • Funding This study was supported by the Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, grant no. VGHKS 104-129, 104-058, 104-133, 103-121, 103-124, 103-G02 and the Ministry of Science and Technology MOST103-2314-B-075B-00.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.