Abstract P328: Statin Reduces Long-term All-cause Mortality In Dialysis Patients With Atherosclerotic Cardiovascular Disease

Abstract

Introduction: Statin therapy is essential for secondary prevention in patients with ASCVD (Atherosclerotic cardiovascular disease). ASCVD is the major contributor to morbidity and mortality in dialysis patients. However, the effects of statin therapy in dialysis patients remain uncertain. Hypothesis: We aimed to assess the hypothesis that statin therapy might decrease long-term mortality in dialysis patients with ASCVD. Method: Patients receiving maintenance dialysis aged ≥ 18 years who had a first-time ASCVD event between 2013 to 2018 were included from the Korean National Health Insurance Service data. Association of statin use with long-term mortality was examined using Cox proportional hazards regression model adjusted for demographics and comorbidities. Results: Among 17,242 dialysis patients, 9,611 (55.7%) patients were prescribed statin after a first-time ASCVD event. Of statin users, moderate-intensity statin accounted for 7,376 (76.7%). During mean follow-up of 32.6 ± 20.9 months, statin use was associated with a decrease in the risk of all-cause mortality than statin non-use after adjusting confounding factors (Hazard ratio [HR]:0.92, 95% confidence interval [CI]:0.88-0.97, p=0.0009). Regarding statin intensity, moderate-intensity statin therapy was associated with a lower risk of all-cause mortality than no statin therapy (HR:0.91, 95% CI:0.87-0.96, p=0.0002). Conclusions: Despite a lack of evidence, more than half of dialysis patients have been prescribed statins after an ASCVD event. In dialysis patients with ASCVD, moderate-intensity statin therapy significantly reduced long-term mortality risk. Statin therapy might be beneficial for secondary prevention in dialysis patients.