Statin therapy for preventing cardiovascular diseases in patients treated with tacrolimus after kidney transplantation

Nayoung Han; Seung Hee Han; Yun Kyoung Song; Myeong Gyu Kim; Yon Su Kim; In Wha Kim; Jung Mi Oh

doi:10.2147/TCRM.S147327

Statin therapy for preventing cardiovascular diseases in patients treated with tacrolimus after kidney transplantation

Nayoung Han, Seung Hee Han, Yun Kyoung Song, Myeong Gyu Kim, Yon Su Kim, In Wha Kim, Jung Mi Oh

Department of Pharmaceutical Sciences

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Background: Lipid abnormalities are prevalent in tacrolimus-treated patients. The aim of the study was to evaluate the preventive effects of statin therapy on major adverse cardiovascular events (MACE) in patients treated with tacrolimus-based immunosuppression after kidney transplantation (KT), and to identify the risk factors. Methods: This observational cohort study included adult patients who underwent KT and were treated with tacrolimus. Patients who received any lipid-lowering agents except statins, or had a history of immunosuppressant use before transplantation were excluded. The primary outcome was the adjusted risk of the first occurrence of MACE. The secondary outcomes included the risk of individual cardiovascular disease (CVD) and changes in cholesterol level. Subgroup analyses were performed in the statin-user group according to the dosage and/or type of statin. Results: Compared with the control group (n=73), the statin-users (n=92) had a significantly reduced risk of MACE (adjusted HR, 0.31; 95% CI, 0.13–0.74). In the Cox regression analysis, old age, history of CVD, and comorbid hypertension were identified as independent factors associated with increased MACE. The total cholesterol levels were not significantly different between the two groups. Subjects with higher cumulative defined daily dose of statins had significantly lower risks of MACE. Conclusion: Statin therapy in patients treated with tacrolimus after KT significantly lowered the risk of MACE. Long-term statin therapy is clearly indicated in older kidney transplant recipients for secondary prevention.

Original language	English
Pages (from-to)	1513-1520
Number of pages	8
Journal	Therapeutics and Clinical Risk Management
Volume	13
DOIs	https://doi.org/10.2147/TCRM.S147327
State	Published - 21 Nov 2017

Bibliographical note

Funding Information:
This research was supported by a grant from the Korea Health technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC15C1045).

Publisher Copyright:
© 2017 Han et al.

Keywords

HMG-CoA reductase inhibitors
Kidney transplantation
Major adverse cardiovascular events (MACE)
Tacrolimus

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10.2147/TCRM.S147327

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title = "Statin therapy for preventing cardiovascular diseases in patients treated with tacrolimus after kidney transplantation",

abstract = "Background: Lipid abnormalities are prevalent in tacrolimus-treated patients. The aim of the study was to evaluate the preventive effects of statin therapy on major adverse cardiovascular events (MACE) in patients treated with tacrolimus-based immunosuppression after kidney transplantation (KT), and to identify the risk factors. Methods: This observational cohort study included adult patients who underwent KT and were treated with tacrolimus. Patients who received any lipid-lowering agents except statins, or had a history of immunosuppressant use before transplantation were excluded. The primary outcome was the adjusted risk of the first occurrence of MACE. The secondary outcomes included the risk of individual cardiovascular disease (CVD) and changes in cholesterol level. Subgroup analyses were performed in the statin-user group according to the dosage and/or type of statin. Results: Compared with the control group (n=73), the statin-users (n=92) had a significantly reduced risk of MACE (adjusted HR, 0.31; 95% CI, 0.13–0.74). In the Cox regression analysis, old age, history of CVD, and comorbid hypertension were identified as independent factors associated with increased MACE. The total cholesterol levels were not significantly different between the two groups. Subjects with higher cumulative defined daily dose of statins had significantly lower risks of MACE. Conclusion: Statin therapy in patients treated with tacrolimus after KT significantly lowered the risk of MACE. Long-term statin therapy is clearly indicated in older kidney transplant recipients for secondary prevention.",

keywords = "HMG-CoA reductase inhibitors, Kidney transplantation, Major adverse cardiovascular events (MACE), Tacrolimus",

author = "Nayoung Han and Han, {Seung Hee} and Song, {Yun Kyoung} and Kim, {Myeong Gyu} and Kim, {Yon Su} and Kim, {In Wha} and Oh, {Jung Mi}",

note = "Funding Information: This research was supported by a grant from the Korea Health technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC15C1045). Publisher Copyright: {\textcopyright} 2017 Han et al.",

year = "2017",

month = nov,

day = "21",

doi = "10.2147/TCRM.S147327",

language = "English",

volume = "13",

pages = "1513--1520",

journal = "Therapeutics and Clinical Risk Management",

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T1 - Statin therapy for preventing cardiovascular diseases in patients treated with tacrolimus after kidney transplantation

AU - Han, Nayoung

AU - Han, Seung Hee

AU - Song, Yun Kyoung

AU - Kim, Myeong Gyu

AU - Kim, Yon Su

AU - Kim, In Wha

AU - Oh, Jung Mi

N1 - Funding Information: This research was supported by a grant from the Korea Health technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC15C1045). Publisher Copyright: © 2017 Han et al.

PY - 2017/11/21

Y1 - 2017/11/21

N2 - Background: Lipid abnormalities are prevalent in tacrolimus-treated patients. The aim of the study was to evaluate the preventive effects of statin therapy on major adverse cardiovascular events (MACE) in patients treated with tacrolimus-based immunosuppression after kidney transplantation (KT), and to identify the risk factors. Methods: This observational cohort study included adult patients who underwent KT and were treated with tacrolimus. Patients who received any lipid-lowering agents except statins, or had a history of immunosuppressant use before transplantation were excluded. The primary outcome was the adjusted risk of the first occurrence of MACE. The secondary outcomes included the risk of individual cardiovascular disease (CVD) and changes in cholesterol level. Subgroup analyses were performed in the statin-user group according to the dosage and/or type of statin. Results: Compared with the control group (n=73), the statin-users (n=92) had a significantly reduced risk of MACE (adjusted HR, 0.31; 95% CI, 0.13–0.74). In the Cox regression analysis, old age, history of CVD, and comorbid hypertension were identified as independent factors associated with increased MACE. The total cholesterol levels were not significantly different between the two groups. Subjects with higher cumulative defined daily dose of statins had significantly lower risks of MACE. Conclusion: Statin therapy in patients treated with tacrolimus after KT significantly lowered the risk of MACE. Long-term statin therapy is clearly indicated in older kidney transplant recipients for secondary prevention.

AB - Background: Lipid abnormalities are prevalent in tacrolimus-treated patients. The aim of the study was to evaluate the preventive effects of statin therapy on major adverse cardiovascular events (MACE) in patients treated with tacrolimus-based immunosuppression after kidney transplantation (KT), and to identify the risk factors. Methods: This observational cohort study included adult patients who underwent KT and were treated with tacrolimus. Patients who received any lipid-lowering agents except statins, or had a history of immunosuppressant use before transplantation were excluded. The primary outcome was the adjusted risk of the first occurrence of MACE. The secondary outcomes included the risk of individual cardiovascular disease (CVD) and changes in cholesterol level. Subgroup analyses were performed in the statin-user group according to the dosage and/or type of statin. Results: Compared with the control group (n=73), the statin-users (n=92) had a significantly reduced risk of MACE (adjusted HR, 0.31; 95% CI, 0.13–0.74). In the Cox regression analysis, old age, history of CVD, and comorbid hypertension were identified as independent factors associated with increased MACE. The total cholesterol levels were not significantly different between the two groups. Subjects with higher cumulative defined daily dose of statins had significantly lower risks of MACE. Conclusion: Statin therapy in patients treated with tacrolimus after KT significantly lowered the risk of MACE. Long-term statin therapy is clearly indicated in older kidney transplant recipients for secondary prevention.

KW - HMG-CoA reductase inhibitors

KW - Kidney transplantation

KW - Major adverse cardiovascular events (MACE)

KW - Tacrolimus

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U2 - 10.2147/TCRM.S147327

DO - 10.2147/TCRM.S147327

M3 - Article

AN - SCOPUS:85048502776

SN - 1176-6336

VL - 13

SP - 1513

EP - 1520

JO - Therapeutics and Clinical Risk Management

JF - Therapeutics and Clinical Risk Management

ER -

Statin therapy for preventing cardiovascular diseases in patients treated with tacrolimus after kidney transplantation

Abstract

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Keywords

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