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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Pravastatin for secondary prevention of cardiovascular events in persons with mild chronic renal insufficiency
Marcello Tonelli1, Lemuel Moyé, Frank M Sacks
1Division of Nephrology and Immunology, University of Alberta, Clinical Sciences Building, Suite 11-108C, 8440 112 Street, Edmonton, Alberta T6B 2B7, Canada.
Annals of Internal Medicine
|January 17, 2003
Summary
Pravastatin effectively reduces cardiovascular events in patients with chronic renal insufficiency. This study indicates statins are safe and beneficial for secondary prevention in this population.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- Cardiovascular disease (CVD) is a leading cause of mortality in individuals with renal insufficiency.
- Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are proven for CVD secondary prevention but lack specific study in chronic renal insufficiency.
Purpose of the Study:
- To evaluate the efficacy and safety of pravastatin for secondary prevention of cardiovascular events in patients with chronic renal insufficiency.
Main Methods:
- Post hoc subgroup analysis of the randomized, double-blind, placebo-controlled Cholesterol and Recurrent Events (CARE) study.
- Included 1711 participants with chronic renal insufficiency (creatinine clearance ≤75 mL/min).
- Primary outcome: death from coronary disease or nonfatal myocardial infarction.
Main Results:
- Pravastatin significantly reduced the primary endpoint (adjusted hazard ratio, 0.72; P=0.02) over 58.9 months.
- Reduced major coronary events and revascularization, with benefits independent of renal insufficiency severity.
- No significant reduction in total mortality or stroke; side effect incidence was similar between groups.
Conclusions:
- Pravastatin is effective and safe for secondary CVD prevention in patients with mild chronic renal insufficiency.
- Statins may be underutilized; consider prescribing for patients with chronic renal insufficiency and coronary disease.
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