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

Introduction: Statin treatment can reduce the risk of cardiovascular disease (CVD). Paradoxically, previous studies have shown that the use of statin is associated with the progression coronary artery calcification (CAC), a well-known predictor of CVD, in individuals with preserved renal function or...

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Main Authors: Jihyun Yang, Kyu-Beck Lee, Hyang Kim, Soo Wan Kim, Yeong Hoon Kim, Su Ah Sung, Jayoun Kim, Kook-Hwan Oh, Ji Yong Jung, Young Youl Hyun
Format: Article
Language:English
Published: Elsevier 2024-10-01
Series:Kidney International Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468024924018631
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author Jihyun Yang
Kyu-Beck Lee
Hyang Kim
Soo Wan Kim
Yeong Hoon Kim
Su Ah Sung
Jayoun Kim
Kook-Hwan Oh
Ji Yong Jung
Young Youl Hyun
author_facet Jihyun Yang
Kyu-Beck Lee
Hyang Kim
Soo Wan Kim
Yeong Hoon Kim
Su Ah Sung
Jayoun Kim
Kook-Hwan Oh
Ji Yong Jung
Young Youl Hyun
author_sort Jihyun Yang
collection DOAJ
description Introduction: Statin treatment can reduce the risk of cardiovascular disease (CVD). Paradoxically, previous studies have shown that the use of statin is associated with the progression coronary artery calcification (CAC), 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 patients with predialysis chronic kidney disease (CKD). The aim of this study was to characterize the relationship between statin use and progression of CAC in a CKD cohort of Korean adults. Methods: We analyzed 1177 participants registered in the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD) cohort. Coronary artery calcium score (CACS) was assessed using cardiac computed tomography at baseline and 4 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. Results: The 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 nonusers. After 4 years, 374 patients (52.0%) demonstrated CAC progression, which was significantly more frequent in statin users than in statin nonusers (218 [58.3%] vs. 156 [41.7%], P < 0.001). The multivariate-adjusted odds ratio for CAC progression in statin users compared to statin nonusers was 1.78 (1.26–2.50). Conclusion: Statin use, significantly and independently, is associated with CAC progression in Korean patients with predialysis CKD. Further research is warranted to verify the prognosis of statin-related CAC progression.
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spelling doaj-art-e245643fcd69461f9f9a2537a0a8c76b2025-08-20T02:33:36ZengElsevierKidney International Reports2468-02492024-10-019103027303410.1016/j.ekir.2024.07.033Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD StudyJihyun Yang0Kyu-Beck Lee1Hyang Kim2Soo Wan Kim3Yeong Hoon Kim4Su Ah Sung5Jayoun Kim6Kook-Hwan Oh7Ji Yong Jung8Young Youl Hyun9Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of KoreaDepartment of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of KoreaDepartment of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of KoreaMedical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of KoreaDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of KoreaDivision of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea; Correspondence: Ji Yong Jung, Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero 774 Beon-gil, Namdonggu, Incheon, 21565, Republic of Korea.Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Young Youl Hyun, Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea.Introduction: Statin treatment can reduce the risk of cardiovascular disease (CVD). Paradoxically, previous studies have shown that the use of statin is associated with the progression coronary artery calcification (CAC), 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 patients with predialysis chronic kidney disease (CKD). The aim of this study was to characterize the relationship between statin use and progression of CAC in a CKD cohort of Korean adults. Methods: We analyzed 1177 participants registered in the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD) cohort. Coronary artery calcium score (CACS) was assessed using cardiac computed tomography at baseline and 4 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. Results: The 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 nonusers. After 4 years, 374 patients (52.0%) demonstrated CAC progression, which was significantly more frequent in statin users than in statin nonusers (218 [58.3%] vs. 156 [41.7%], P < 0.001). The multivariate-adjusted odds ratio for CAC progression in statin users compared to statin nonusers was 1.78 (1.26–2.50). Conclusion: Statin use, significantly and independently, is associated with CAC progression in Korean patients with predialysis CKD. Further research is warranted to verify the prognosis of statin-related CAC progression.http://www.sciencedirect.com/science/article/pii/S2468024924018631chronic kidney diseasecoronary artery calcificationstatin
spellingShingle Jihyun Yang
Kyu-Beck Lee
Hyang Kim
Soo Wan Kim
Yeong Hoon Kim
Su Ah Sung
Jayoun Kim
Kook-Hwan Oh
Ji Yong Jung
Young Youl Hyun
Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study
Kidney International Reports
chronic kidney disease
coronary artery calcification
statin
title Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study
title_full Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study
title_fullStr Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study
title_full_unstemmed Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study
title_short Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study
title_sort statin use and the progression of coronary artery calcification in ckd findings from the know ckd study
topic chronic kidney disease
coronary artery calcification
statin
url http://www.sciencedirect.com/science/article/pii/S2468024924018631
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