Atorvastatin and Low-Density Lipoprotein Cholesterol in Type 2 Diabetes Mellitus Patients on Hemodialysis

• DOI: 10.2215/cjn.09121010
• Publication Date: 2011-04-15T02:38:55Z
• Authors: Winfried März; Bernd Genser; Christiane Drechsler; Vera Krane; Tanja B. Grammer; Eberhard Ritz; Tatjana Stojakovic; Hubert Scharnagl; Karl Winkler; Ingar Holme; Hallvard Holdaas; Christoph Wanner
• Keywords: Low-density lipoprotein

Summary Background and objectives Patients undergoing maintenance hemodialysis are at high cardiovascular risk. Lowering LDL-cholesterol with statins reduces the incidence rate of events in patients chronic kidney disease. In contrast, two randomized, prospective, placebo-controlled trials have been completed that showed no significant effects on outcomes. Design, setting, participants, & measurements A post hoc analysis was conducted 4D (Die Deutsche Diabetes Dialyze) study to investigate whether baseline is predictive effect atorvastatin clinical outcomes depends baseline. Results High concentrations by tendency increased risks cardiac endpoints all-cause mortality. Concordantly, significantly reduced rates adverse highest quartile (≥145 mg/dl, 3.76 mmol/L). The hazard ratios 95% confidence intervals were 0.69 (0.48 1.00) for composite primary endpoint, 0.58 (0.34 0.99) death, 0.48 (0.25 0.94) sudden 0.62 (0.33 1.17) nonfatal myocardial infarction, 0.68 (0.47 0.98) all combined, 0.72 (0.52 death from causes, respectively. No such decrease seen any other quartiles Conclusions type 2 diabetes mellitus hemodialysis, risk fatal cause if pretreatment >145 mg/dl (3.76