Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study

Abstract

IntroductionStatin treatment can reduce the risk of cardiovascular disease (CVD). Paradoxically, previous studies have shown that the use of statin is associated with the progression CAC (coronary artery calcification), a well-known predictor of CVD, in individuals with preserved renal function or in patients on dialysis. However, little is known about the association in predialysis CKD (chronic kidney disease) patients. The aim of this study was to characterize the relationship between statin use and progression of CAC in a CKD cohort of Korean adults. MethodsWe analyzed 1,177 participants registered in the KNOW-CKD cohort. Coronary artery calcium score (CACS) was assessed using cardiac computed tomography at baseline and four years after enrollment. CAC progression was defined using the Sevrukov method. Statin users were defined as those who used statins for 50% or more of the follow-up period. ResultsThe median [interquartile range] of CACS was 0 [0-30.33], and 318 (44.2%) participants had CACS above 0 at baseline. There were 447 (38.0%) statin users and 730 (62.0%) statin non-users. After four years, 374 (52.0%) patients demonstrated CAC progression, which was significantly more frequent in statin users than in statin non-users (218 [58.3%] vs. 156 [41.7%], P<0.001). The multivariate-adjusted odds ratio for CAC progression in statin users compared to statin non-users was 1.78 (1.26-2.50). ConclusionStatin use significantly and independently is associated with CAC progression in Korean predialysis CKD patients. Further research is warranted to verify the prognosis of statin-related CAC progression.