Rosuvastatin in Diabetic Hemodialysis Patients
| Autor: | Hallvard Holdaas, Bengt Fellström, Ingar Holme, Roland E. Schmieder, Faiez Zannad, Gudrun E. Norby, Alan G. Jardine |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Diabetes Complications Double-Blind Method Renal Dialysis AURORA trial Internal medicine Diabetes mellitus Clinical endpoint Humans Medicine Clinical Epidemiology Rosuvastatin Myocardial infarction Rosuvastatin Calcium Stroke Aged Aged 80 and over Sulfonamides business.industry nutritional and metabolic diseases General Medicine Middle Aged medicine.disease Lipids Surgery Fluorobenzenes C-Reactive Protein Pyrimidines Nephrology Cardiology Kidney Failure Chronic Female Hemodialysis Hydroxymethylglutaryl-CoA Reductase Inhibitors business medicine.drug |
| Zdroj: | Journal of the American Society of Nephrology. 22:1335-1341 |
| ISSN: | 1046-6673 |
| DOI: | 10.1681/asn.2010090987 |
| Popis: | A randomized, placebo-controlled trial in diabetic patients receiving hemodialysis showed no effect of atorvastatin on a composite cardiovascular endpoint, but analysis of the component cardiac endpoints suggested that atorvastatin may significantly reduce risk. Because the AURORA (A Study to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events) trial included patients with and without diabetes, we conducted a post hoc analysis to determine whether rosuvastatin might reduce the risk of cardiac events in diabetic patients receiving hemodialysis. Among the 731 participants with diabetes, traditional risk factors such as LDL-C, smoking, and BP did not associate with cardiac events (cardiac death and nonfatal myocardial infarction). At baseline, only age and high-sensitivity C-reactive protein were independent risk factors for cardiac events. Assignment to rosuvastatin associated with a nonsignificant 16.2% reduction in risk for the AURORA trial's composite primary endpoint of cardiac death, nonfatal MI, or fatal or nonfatal stroke (HR 0.84; 95% CI 0.65 to 1.07). There was no difference in overall stroke, but the rosuvastatin group had more hemorrhagic strokes than the placebo group (12 versus two strokes, respectively; HR, 5.21; 95% CI 1.17 to 23.27). Rosuvastatin treatment significantly reduced the rates of cardiac events by 32% among patients with diabetes (HR 0.68; 95% CI 0.51 to 0.90). In conclusion, among hemodialysis patients with diabetes mellitus, rosuvastatin might reduce the risk of fatal and nonfatal cardiac events. |
| Databáze: | OpenAIRE |
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