Statins ‘may improve prognosis’ in renovascular disease
MedWire News: The use of statins is associated with a reduced risk for vascular events among elderly patients with renovascular disease, a cohort study has found.
The Canadian researchers suggest that renovascular disease, which is usually caused by atherosclerosis, may be a new potential indication for statin therapy.
Their findings are based on a population-based cohort study in 4040 patients aged 65 years and older, all of whom were diagnosed with renovascular disease. The patients were followed-up for a median of 3.3 years for the occurrence of cardiorenal events (myocardial infarction, stroke, acute renal failure, dialysis, or death).
Writing in the European Heart Journal, the authors report that 42% of the cohort was receiving a statin at baseline. Cardiovascular risk factors and comorbidities were highly prevalent overall, and even more common among statin users than in nonusers.
In unadjusted analyses, the use of statins was associated with a substantially lower risk for cardiorenal events, with a hazard ratio (HR) of 0.51 compared with nonuse.
This association was unchanged after adjusting for demographic characteristics, cardiovascular risk factors, comorbidities, measures of healthcare utilization, screening, and concomitant medications (adjusted HR=0.51).
Analysis of individual endpoints revealed that statins were associated with a reduced risk for stroke (HR=0.72), heart failure (HR=0.83), dialysis (HR=0.66), and death (HR=0.27), and with a trend toward fewer myocardial infarctions (HR=0.82).
The validity of these results was reinforced by a propensity score analysis that matched 1061 statin user and nonuser control pairs, yielding a significant (albeit more conservative) HR of 0.82 for the primary composite endpoint.
Daniel Hackam (University of Western Ontario, London, Canada) and fellow authors write: "These findings suggest an association between statins and cardiorenal prognosis in patients with renovascular disease.
"While randomized data do not exist to guide the nature of medical therapy for this condition, our findings suggest that patients with renovascular disease should potentially be considered for statin therapy."
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By Joanna Lyford