Author + information
- Prakash C. Deedwania,
- Andrei Breazna,
- David DeMicco,
- John C. LaRosa,
- James Shepherd,
- Matti J. Tikkanen,
- Ingar Holme,
- Anders G. Olsson and
- Terje Pedersen
Studies show that renal function improves with statin therapy in coronary patients with CKD, but few studies show a relationship between cholesterol and CKD. As many patients with CKD have dyslipidemia there is a need to evaluate the relationship between lipoproteins and CKD.
We analyzed data from a large cohort of coronary patients from the TNT (atorvastatin 10 mg vs atorvastatin 80 mg) and IDEAL (simvastatin 20-40 mg vs atorvastatin 80 mg) studies. Age- and multivariable-adjusted relative risks and 95% confidence intervals for CKD were calculated according to baseline TC, HDL-C, LDL-C, Non-HDL-C, TC/HDL-C and apoB/apoA. Multivariable model 1 adjusted for baseline age, smoking status, diabetes (history or during follow-up), baseline BMI, history of hypertension, and treatment assignment. Model 2 utilized these variables and development of cardiovascular disease.
HDL-C, non-HDL-C, TC, apoB/apoA and TC/HDL-C were consistently associated with an increased risk of CKD (Table). Using the multivariable models, the lipoprotein components that were associated with highest risk of CKD were a high ratio of TC/HDL-C, high non-HDL-C, and elevated TC.
In the present study, baseline lipoprotein levels were significantly associated with an increased risk of CKD. Multivariate analyses identified TC, HDL-C, non-HDL-C, apoB/apoA1 ratio, and TC/HDL-C ratio as significant predictors; age-adjusted analyses found LDL-C to be significant predictor.
|Lipoprotein parameter||Age-adjusted||Multivariable Model 1||Multivariable Model 2|
|RR||95% CI||P||RR||95% CI||P||RR||95% CI||P|
|TC||1.13||0.99 – 1.29||0.1118||1.35||1.18 – 1.56||<0.0001||1.34||1.17 – 1.55||<0.0001|
|HDL-C||1.11||1.03 – 1.20||0.0046||1.12||1.04 – 1.21||0.0027||1.12||1.03 – 1.21||0.0045|
|LDL-C||0.84||0.77 – 0.93||0.0004||1.02||0.92 – 1.13||0.1778||1.01||0.92 – 1.12||0.1770|
|non-HDL-C||1.20||1.05 – 1.36||0.0015||1.45||1.26 – 1.66||<0.0001||1.43||1.25 – 1.65||<0.0001|
|apoB/apoA1||1.11||1.01 – 1.22||0.0027||1.15||1.05 – 1.27||0.0007||1.14||1.04 – 1.26||0.0015|
|TC/HDL-C||1.34||1.11 – 1.62||<0.0001||1.58||1.30 – 1.92||<0.0001||1.56||1.29 – 1.90||<0.0001|
↵* RR and 95% CI for top versus bottom category of TC, LDL-C, non-HDL-C, apoB/apoA1, TC/HDL-C, and bottom versus top category of HDL-C; eGFR = estimated glomerular filtration rate.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Rock and a Hard Place: Chronic Kidney Disease and the Heart
Abstract Category: 10. Chronic CAD/Stable Ischemic Heart Disease: Clinical
Presentation Number: 1193-59
- 2013 American College of Cardiology Foundation