Effect of statins on cardiovascular events in patients with mild to moderate chronic kidney disease: a systematic review and meta-analysis of randomized clinical trials

BMC Cardiovascular Disorders

Research Article

Ying-Yi Qin¹  Jia He¹  Chun Xiang¹  Xiao Zhang¹  Yu-Hao Zhou²  An Jiang³ 

[1] Department of Health Statistics, Second Military Medical University, 200433, Shanghai, China;Department of Rehabilitation Institute, Shanghai Seventh People’s Hospital, Shanghai, China;Office of Educational Administration, Second Military Medical University, Shanghai, China;

关键词: Statin;    Cardiovascular events;    Chronic kidney disease;    Meta-analysis;   

DOI  :  10.1186/1471-2261-14-19

 received in 2012-09-28, accepted in 2014-02-11,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundStatins are commonly used to lower total cholesterol levels in the general population to prevent cardiovascular events. However, the effects of statins in patients with chronic kidney disease remain unclear. We therefore performed a meta-analysis to assess the effects of statin therapy on cardiovascular outcomes in patients with mild to moderate chronic kidney disease.MethodsWe systematically searched PubMed, EmBase, the Cochrane Central Register of Controlled Trials, proceedings of major meetings, and reference lists of articles for relevant literature. Only randomized clinical trials were included. Outcomes analysed included cardiovascular disease, total mortality, myocardial infarction, stroke, cardiovascular death, and possible drug-related adverse events. Subgroup analyses were also performed based on the population characteristics and clinical indexes.ResultsTwelve trials met our inclusion criteria. Overall, statin therapy resulted in a 24% reduction in the risk of cardiovascular disease (RR = 0.76,95% confidence interval [CI], 0.72– 0.80), a 21% reduction in the risk of total mortality (RR = 0.79,95% CI, 0.72–0.86), a 34% reduction in the risk of myocardial infarction (RR = 0.66,95% CI, 0.52–0.83), a 30% reduction in the risk of stroke (RR = 0.70,95% CI, 0.57–0.85), and a 17% reduction in the risk of cardiovascular mortality (RR = 0.83,95% CI, 0.73– 0.93). No statistically significant drug-related adverse events were noted. Subgroup analysis indicated that some important factors such as baseline creatinine level ≥1.5 mg/dL, baseline glomerular filtration rate (GFR), and cardiovascular disease history could affect cardiovascular outcomes.ConclusionStatin therapy had a clear effect on cardiovascular disease, total mortality, stroke, and myocardial infarction in patients with mild to moderate renal disease. Subgroup analysis indicated that baseline GFR, baseline creatinine level, and a history of cardiovascular disease might play an important role in the cardiovascular outcomes.

【 授权许可】

Unknown   
© Zhang et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.