Abstract 10258: Do Statins Impact Long-term Mortality Peripheral Artery Disease Patients Who Have End Stage Renal Disease?

Abstract

Introduction: Statins have shown mortality benefit in peripheral artery disease (PAD), their impact in end-stage renal disease (ESRD) patients with PAD is not well studied. Hypothesis: Does statin utilization have any impact on mortality in ESRD patients with PAD? Methods: We included ESRD Medicare beneficiaries from the United states Renal Database (Jan 1 st 2006 to May 31 st 2017) with PAD within 6 months of incident dialysis. Medicare part D claims were used to determine STU during the follow-up period. Fractional polynomial regression across varying % of STU was generated to predict 2-year mortality. Results: Out of 45,424 ESRD patients with PAD, 62.3% received no statins while the rest had at least some duration of STU. ST was bimodally distributed, with median utilization of 0% (IQR= 0-90%). Mortality was 41.7% over a median follow-up of 472 days. Univariate association of STU on mortality yielded odds ratio (OR) of 0.99 (95% CI = 0.992-0.993; p<0.001). Model 1 including baseline demographics and comorbidities (age, sex, body mass index, hypertension, coronary artery disease, stroke, smoking, diabetes, and heart failure) an AUC of 0.65. The addition of STU (Model 2) resulted in only minimal improvement in the AUC (0.65 vs 0.67; p<0.01). Conclusions: Statin utilization in ESRD patients is associated with only borderline statistically significant reduction in mortality (≈0.1%) of unclear clinical implications