Beneficial effect of early initiation of lipid-lowering therapy following renal transplantation

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2005-05, Vol.20 (5), p.974-980
• Main Authors: Holdaas, Hallvard, Fellström, Bengt, Jardine, Alan G., Nyberg, Gudrun, Grönhagen-Riska, Carola, Madsen, Sören, Neumayer, Hans-Hellmut, Cole, Edward, Maes, Bart, Ambühl, Patrice, Logan, John O., Staffler, Beatrix, Gimpelewicz, Claudio
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; cardiac end-points; Cholesterol, LDL - blood; Death; Dermatologi och venerologi, klinisk genetik, invärtesmedicin; Dermatology and venerology,clinical genetics, internal medicine; Emergency and intensive care: renal failure. Dialysis management; Fatty Acids, Monounsaturated - therapeutic use; Female; fluvastatin; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Indoles - therapeutic use; Intensive care medicine; Internal medicine; Invärtesmedicin; Kidney diseases; Kidney Transplantation - adverse effects; Male; Medical sciences; MEDICIN; MEDICINE; Middle Aged; Myocardial Infarction - prevention & control; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Njursjukdomar; Renal failure; renal transplant recipients; Risk Reduction Behavior; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system
• ISSN: 0931-0509; 1460-2385; 1460-2385
• DOI: 10.1093/ndt/gfh735

Background. Renal transplant recipients have a significantly reduced life expectancy, largely due to premature cardiovascular disease. The aim of the current analysis was to investigate the importance of time of initiation of therapy after transplantation, on the benefits of statin therapy. Methods. 2102 renal transplant recipients with total cholesterol levels of 4.0–9.0 mmol/l were randomly assigned to treatment with fluvastatin (n = 1050) or placebo (n = 1052) and followed for a mean time of 5.1 years. The end-points were major cardiac events. The average median time from transplantation to randomization was 4.5 years (range: 0.5–29 years). Results. In patients starting treatment with fluvastatin 6 years, respectively. The risk reduction for patients initiating therapy with fluvastatin at years 0–2 (compared with >6 years) following transplantation was 59% (RR: 0.41; 95% CI: 0.18–0.92; P = 0.0328). This is also reflected in total time on renal replacement therapy: in patients in the first quartile (120 months) (P = 0.033). Conclusions. Our data support an early introduction of fluvastatin therapy in a population of transplant recipients at high risk of premature coronary heart disease.