Effect of Statin on the 5 Years Clinical Outcomes in Dialysis Patients Treated with Sirolimus-eluting Stent

• Published in: Internal Medicine Vol. 53; no. 2; pp. 89 - 94
• Main Authors: Kagawa, Yuzo, Toyofuku, Mamoru, Masaoka, Yoshiko, Muraoka, Yuji, Okimoto, Tomokazu, Otsuka, Masaya, Tamekiyo, Hiromichi, Mito, Shinji, Kawase, Tomoharu, Yamane, Kenichi, Amioka, Michitaka, Shiode, Nobuo, Hayashi, Yasuhiko
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-01-2014
• Subjects: Aged; Biomarkers; Cause of Death; Comorbidity; Coronary Disease - complications; Coronary Disease - drug therapy; Coronary Disease - surgery; dialysis; Drug-Eluting Stents; Dyslipidemias - complications; Dyslipidemias - drug therapy; Female; Follow-Up Studies; Heart Failure - etiology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Kaplan-Meier Estimate; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Male; Middle Aged; Myocardial Revascularization - statistics & numerical data; Proportional Hazards Models; Renal Dialysis; Retrospective Studies; Sirolimus - administration & dosage; Sirolimus - therapeutic use; sirolimus-eluting stent; statin; Treatment Outcome
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.53.1122

Objective The optimal medication therapies are recommended in patients with coronary artery disease even after the coronary revascularization. However, the information of optimal medical therapy in dialysis population is scant. We assessed the efficacy of statin on the clinical outcomes after Sirolimus-eluting stent (SES) implantation in patients with and without dialysis. Methods and Results We analyzed date from 843 consecutive patients who successfully treated with SES in our institution between August 2004 and November 2006. Among patients, 96 patients (11.4%) were undergoing dialysis. In non-dialysis patients, 405 patients (54%) were treated with statin at hospital discharge. In dialysis patients, only 16 patients (17%) were treated with statin. In non-dialysis patients, mortality rate was significantly lower in patients treated with statin than those without statin (4.4% vs. 13.9%, p<0.0001). While in dialysis patients, mortality rate was similar between patients treated with and without statin (56.3% vs. 57.6%, p=0.86). After adjusting for confounders, the hazard ratios for mortality were 0.39 (95% confidence interval (CI), 0.14-0.99; p=0.047) in non-dialysis patients and 1.79 (95% CI, 0.39-7.86; 0.45) for dialysis patients. The interaction probability between statin use and dialysis for mortality was 0.016. Conclusion The use of statin may have beneficial effect on reducing mortality rate in patients after SES implantation in non-dialysis patients. However, such favorable effect was not observed in dialysis population.