| Title: |
Atherosclerotic Cardiovascular Disease Events in Adults With CKD Taking a Moderate- or High-Intensity Statin: The Chronic Renal Insufficiency Cohort (CRIC) Study |
| Authors: |
Poudel, B; Rosenson, RS; Bittner, V; Gutiérrez, OM; Anderson, AH; Woodward, M; Deo, R; Carson, AP; Mues, KE; Dluzniewski, PJ; Jaar, BG; Lora, CM; Taliercio, J; Muntner, P; Colantonio, LD |
| Source: |
urn:ISSN:2590-0595 ; Kidney Medicine, 3, 5, 722-731.e1 |
| Publisher Information: |
Elsevier |
| Publication Year: |
2021 |
| Collection: |
UNSW Sydney (The University of New South Wales): UNSWorks |
| Subject Terms: |
32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; Women's Health; Health Disparities; Cardiovascular; Kidney Disease; Heart Disease; Health Disparities and Racial or Ethnic Minority Health Research; Minority Health; Atherosclerosis; Aging; Clinical Research; 6.1 Pharmaceuticals; 3 Good Health and Well Being; American Heart Association/American College of Cardiology cholesterol guideline; atherosclerotic cardiovascular disease; chronic kidney disease; moderate- or high-intensity statin; risk assessment; Chronic Renal Insufficiency Cohort (CRIC) Study Investigators; anzsrc-for: 32 Biomedical and Clinical Sciences; anzsrc-for: 3202 Clinical Sciences |
| Description: |
Rationale & Objective: The 2018 American Heart Association/American College of Cardiology (AHA/ACC) cholesterol guideline uses risk stratification to guide the decision to initiate nonstatin lipid-lowering medication among adults with atherosclerotic cardiovascular disease (CVD). We determined atherosclerotic CVD (ASCVD) event rates among adults with chronic kidney disease (CKD) taking statin therapy within 2018 AHA/ACC cholesterol guideline risk categories. Study Design: Observational cohort study. Setting & Participants: Adults with CKD not on dialysis in the Chronic Renal Insufficiency Cohort (CRIC) study who were taking a moderate/high-intensity statin 1 year after enrollment (baseline for the current analysis, n = 1,753). Exposure: 2018 AHA/ACC cholesterol guideline risk categories: without a history of ASCVD, a history of 1 major ASCVD event and multiple high-risk conditions, and a history of ≥2 major ASCVD events. Outcome: Adjudicated ASCVD events after the year 1 study visit. Analytical Approach: We calculated age-sex standardized rates for ASCVD events and age-sex adjusted hazard ratios for ASCVD events accounting for the competing risk of death. Results: There were 394 ASCVD events over a median follow-up period of 8 years. The ASCVD event rates (with 95% CI) per 1,000 person-years among participants without a history of ASCVD, with a history of 1 major ASCVD event and multiple high-risk conditions, and with a history of ≥2 major ASCVD events were 21.7 (18.4-25.1), 45.0 (37.8-52.3), and 73.3 (53.3-93.4), respectively. Compared with participants without a history of ASCVD, the HR (95% CI) rates for ASCVD events among those with a history of 1 major ASCVD event and multiple high-risk conditions, and with a history of ≥2 major ASCVD events were 1.89 (1.52-2.36) and 2.50 (1.85-3.39), respectively. Limitations: Data on whether participants were taking a maximally tolerated statin dosage were unavailable. Conclusions: The 2018 AHA/ACC cholesterol guideline identifies adults with CKD who have very ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
https://hdl.handle.net/1959.4/unsworks_84384; https://doi.org/10.1016/j.xkme.2021.04.008 |
| DOI: |
10.1016/j.xkme.2021.04.008 |
| Availability: |
https://hdl.handle.net/1959.4/unsworks_84384; https://unsworks.unsw.edu.au/bitstreams/3865a614-a1cd-46a6-96d9-bdabc8f5e9e0/download; https://doi.org/10.1016/j.xkme.2021.04.008 |
| Rights: |
open access ; https://purl.org/coar/access_right/c_abf2 ; CC BY-NC-ND ; https://creativecommons.org/licenses/by-nc-nd/4.0/ ; free_to_read |
| Accession Number: |
edsbas.B46843C2 |
| Database: |
BASE |