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Effect of Statin Use on Mortality in Individuals With Cardiovascular-Kidney-Metabolic Syndrome: A Retrospective
Cheng Yuan1, Yuguo Ge2, Wenqi Ge3
1Department of Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China, bbmc.edu.cn.
Insights
Statins significantly reduce mortality in individuals with cardiovascular-kidney-metabolic syndrome (CKMS). This study found statin use associated with lower all-cause and cardiovascular death risks in CKMS patients.
Area of Science:
- Cardiology
- Nephrology
- Metabolic Syndrome Research
Background:
- Cardiovascular-kidney-metabolic syndrome (CKMS) poses significant mortality risks.
- Investigating the impact of statins on mortality in CKMS patients is crucial for clinical practice.
Purpose of the Study:
- To evaluate the association between statin use and all-cause and cardiovascular mortality in individuals diagnosed with CKMS.
- To explore potential variations in statin effectiveness based on disease stage, statin type, and lipid profiles.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018.
- Employed propensity score matching (PSM) to create comparable statin-treated and untreated CKMS cohorts.
- Assessed all-cause and cardiovascular mortality outcomes.
Main Results:
- Statin therapy was linked to a 27% reduction in all-cause mortality and a 26% decrease in cardiovascular mortality among CKMS individuals.
- Atorvastatin and simvastatin showed benefits for both mortality types; rosuvastatin primarily for all-cause mortality.
- Mortality benefits were more pronounced in individuals with intermediate total and LDL cholesterol levels.
Conclusions:
- Statin use is associated with reduced all-cause and cardiovascular mortality in a nationally representative cohort of CKMS patients.
- Further research with larger prospective studies is needed to confirm findings and explore heterogeneity.
Background:
The present study is aimed at investigating the effects of statins on all-cause and cardiovascular mortalities in individuals with cardiovascular-kidney-metabolic syndrome (CKMS).
Methods:
Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, we identified individuals with CKMS and categorized them into statin-treated and untreated groups based on statin exposure. A propensity score matching (PSM) model was applied to balance baseline characteristics between the two groups. All-cause and cardiovascular mortalities were then assessed.
Results:
A total of 19087 individuals with CKMS were enrolled, yielding 4762 matched individuals. Compared with the statin-untreated group, statin therapy was associated with significant mortality benefits in CKMS individuals, demonstrating a 27% reduction in all-cause mortality (HR 0.73, 95% CI 0.65-0.82) and a 26% decrease in cardiovascular mortality (HR 0.74, 95% CI 0.61-0.90). Stratified analyses by CKMS stage showed no significant interaction between disease stage and statin use for either all-cause (p for interaction = 0.81) or cardiovascular mortality (p for interaction = 0.13), although statistically significant inverse associations were primarily observed in individuals with advanced CKMS stages. Analyses by statin type indicated that atorvastatin and simvastatin were associated with reduced risks of both all-cause and cardiovascular mortalities, whereas rosuvastatin was associated with a reduced risk of all-cause mortality only. Exploratory subgroup analyses suggested that the associations were more evident among individuals with intermediate levels of total cholesterol (200-240 mg/dL) and LDL cholesterol (130-160 mg/dL).
Conclusion:
In this nationally representative cohort, statin use was associated with lower risks of all-cause and cardiovascular mortalities among individuals with CKMS. These findings warrant confirmation in prospective studies with larger sample sizes to further clarify potential heterogeneity across statin type, disease stages, and different lipid profiles.
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