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Focused atorvastatin therapy in managed-care patients with coronary heart disease and CKD

Michael J Koren1, Michael H Davidson, Daniel J Wilson

  • 1Jacksonville Center for Clinical Research, Jacksonville, FL 32216, USA. michaelkoren@jaxresearch.com

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|February 14, 2009
PubMed

Insights

Patients with coronary heart disease and chronic kidney disease face higher cardiovascular event risks. Atorvastatin therapy effectively reduced this risk in real-world settings, showing similar benefits for patients with and without chronic kidney disease.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Coronary heart disease (CHD) and chronic kidney disease (CKD) are significant risk factors for cardiovascular events.
  • Investigating the impact of atorvastatin therapy in patients with CHD, with or without CKD, is crucial for optimizing cardiovascular care.

Purpose of the Study:

  • To evaluate the effectiveness of focused atorvastatin therapy versus usual care on cardiovascular outcomes in patients with CHD and varying CKD statuses.
  • To determine if CKD influences the efficacy of atorvastatin in reducing cardiovascular events.

Main Methods:

  • A post hoc analysis of the ALLIANCE Study involving 2,442 patients with CHD and dyslipidemia.
  • Patients were randomized to focused atorvastatin therapy (LDL-C < 80 mg/dL or max 80 mg/d) or usual care.
  • CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2).

Main Results:

  • Patients with CHD and CKD (23.7%) had a higher incidence of cardiovascular events (31.6%) compared to those without CKD (23.6%).
  • Atorvastatin therapy reduced the relative risk of cardiovascular events by 28% in patients with CKD and 11% in patients without CKD.
  • No significant difference in treatment effect was observed between patients with and without CKD (P for interaction = 0.2).

Conclusions:

  • Patients with CHD and CKD are at elevated risk for cardiovascular events.
  • Focused atorvastatin treatment demonstrates efficacy in reducing cardiovascular risk in patients with CHD, irrespective of CKD status.
  • Atorvastatin therapy did not negatively impact renal function (eGFR) during the study period.
Abstract

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