Abstract | BACKGROUND: METHODS AND RESULTS: We analyzed data from the Pravastatin Pooling Project (PPP), a subject-level database combining results from 3 randomized trials of pravastatin (40 mg daily) versus placebo. Of 19 700 subjects, 4491 (22.8%) had moderate CKD, defined by an estimated glomerular filtration rate of 30 to 59.99 mL/min per 1.73 m2 body surface area. The primary outcome was time to myocardial infarction, coronary death, or percutaneous/surgical coronary revascularization. Moderate CKD was independently associated with an increased risk of the primary outcome (adjusted HR 1.26, 95% CI 1.07 to 1.49) compared with those with normal renal function. Among the 4491 subjects with moderate CKD, pravastatin significantly reduced the incidence of the primary outcome (HR 0.77, 95% CI 0.68 to 0.86), similar to the effect of pravastatin on the primary outcome in subjects with normal kidney function (HR 0.78, 95% CI 0.65 to 0.94). Pravastatin also appeared to reduce the total mortality rate in those with moderate CKD (adjusted HR 0.86, 95% CI 0.74 to 1.00, P=0.045). CONCLUSIONS:
Pravastatin reduces cardiovascular event rates in people with or at risk for coronary disease and concomitant moderate CKD, many of whom have serum creatinine levels within the normal range. Given the high risk associated with CKD, the absolute benefit that resulted from use of pravastatin was greater than in those with normal renal function.
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Authors | Marcello Tonelli, Chris Isles, Gary C Curhan, Andrew Tonkin, Marc A Pfeffer, James Shepherd, Frank M Sacks, Curt Furberg, Stuart M Cobbe, John Simes, Timothy Craven, Malcolm West |
Journal | Circulation
(Circulation)
Vol. 110
Issue 12
Pg. 1557-63
(Sep 21 2004)
ISSN: 1524-4539 [Electronic] United States |
PMID | 15364796
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Creatinine
- Pravastatin
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Topics |
- Adult
- Aged
- Angioplasty, Balloon, Coronary
(statistics & numerical data)
- Cardiovascular Diseases
(complications, epidemiology, prevention & control)
- Chronic Disease
- Comorbidity
- Coronary Disease
(complications)
- Creatinine
(blood)
- Databases, Factual
- Double-Blind Method
- Drug Evaluation
- Female
- Glomerular Filtration Rate
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
(therapeutic use)
- Hypercholesterolemia
(complications, drug therapy)
- Kidney Diseases
(complications)
- Male
- Middle Aged
- Myocardial Infarction
(epidemiology, prevention & control)
- Myocardial Revascularization
(statistics & numerical data)
- Pravastatin
(therapeutic use)
- Randomized Controlled Trials as Topic
(statistics & numerical data)
- Risk
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