Effect of Statins on the Progression of Coronary Calcification in Kidney Transplant Recipients

PLoS One. 2016 Apr 21;11(4):e0151797. doi: 10.1371/journal.pone.0151797. eCollection 2016.

Abstract

Background: Coronary calcification (CAC) is highly prevalent in kidney transplant recipients (KTRs) and has been associated with cardiovascular morbidity and mortality. Some studies have shown a reduction in CAC progression with statin therapy in the general and chronic kidney disease (CKD) populations.

Objectives and methods: The aim of the present study was to evaluate the effect of statins on CAC progression in incident kidney transplant recipients. Patients were randomly assigned to the statin (n = 61, 10 mg daily) and control group (n = 59). CAC and biochemical analyses were performed at baseline and 12 months.

Results: At baseline, CAC was observed in 30% and 21% of patients in the statin and control groups, respectively (p = 0.39). The calcium score at baseline and its absolute and relative changes over 12 months of follow up were similar among the groups. In the statin group, total cholesterol (p < 0.001), low density lipoprotein cholesterol (p < 0.001) and triglycerides (p = 0.005) decreased, and the estimated glomerular function rate increased (p<0.001) significantly. CRP levels remained stable (p = 0.52) in the statin group but increased in the control group (p = 0.01). In the multivariate model, there was no difference in CAC progression between the groups (group effect p = 0.034; time-effect p = 0.23; interaction p = 0.74). Similar results were obtained when only patients with ≥ 10AU calcium score (calcified) were analyzed (group effect p = 0.051; time-effect p = 0.58; interaction p = 0.99).

Conclusion: Although statins reduce the levels of cholesterol, triglycerides, inflammation and improve graft function, the dose adopted in the current study did not delay CAC progression within 12 months of follow up.

Trial registration: Brazilian Clinical Trials Registry RBR-32RFMB.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Calcification, Physiologic / drug effects*
  • Calcinosis / drug therapy*
  • Cholesterol / metabolism
  • Cholesterol, LDL / metabolism
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / etiology
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Kidney Transplantation / methods
  • Male
  • Prospective Studies
  • Renal Insufficiency, Chronic / complications
  • Transplant Recipients
  • Triglycerides / metabolism

Substances

  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Triglycerides
  • Cholesterol

Associated data

  • ReBec/RBR-32RFMB

Grants and funding

Fundação de ampara a pesquisa do estado de São Paulo (FAPESP). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.