Fluvastatin prevents cardiac death and myocardial infarction in renal transplant recipients: post-hoc subgroup analyses of the ALERT Study

Fluvastatin prevents cardiac death and myocardial infarction in renal transplant recipients : post-hoc subgroup analyses of the ALERT Study

Jardine, Alan G. (author)

Holdaas, Hallvard (author)

Fellström, Bengt (author): Uppsala universitet,Institutionen för medicinska vetenskaper

Cole, Edward (author)

Nyberg, Gudrun (author)

Grönhagen-Riska, Carola (author)

Madsen, Sören (author)

Neumayer, Hans-Hellmut (author)

Maes, Bart (author)

Ambühl, Patrice (author)

Olsson, Anders, 1940- (author): Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Internmedicin,Endokrin- och magtarmmedicinska kliniken US

Holme, Ingar (author)

Fauchald, Per (author)

Gimpelwicz, Claudio (author)

Pedersen, Terje R. (author)

(creator_code:org_t)

Elsevier BV, 2004
2004
English.
In: American Journal of Transplantation. - : Elsevier BV. - 1600-6135 .- 1600-6143. ; 4:6, s. 988-995

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Abstract Subject headings

Renal transplant recipients have a greatly increased risk of premature cardiovascular disease. The ALERT study was a multicenter, randomized, double-blind, placebo-controlled trial of fluvastatin (40-80 mg/day) in 2102 renal transplant recipients followed for 5-6 years. The main study used a composite cardiac end-point including myocardial infarction, cardiac death and cardiac interventions. Although reduced by fluvastatin, this primary end-point failed to achieve statistical significance thus precluding analysis of predefined subgroups. Therefore, in the present survival analysis, we used an alternative primary end-point of cardiac death or definite nonfatal myocardial infarction (as used in other cardiac outcome trials) which was significantly reduced by Fluvastatin therapy and permits subgroup analysis. Fluvastatin reduced LDL-cholesterol by 1 mmol/L compared with placebo, and the incidence of cardiac death or definite myocardial infarction was reduced from 104 to 70 events (RR 0.65; 95% CI 0.48, 0.88; p = 0.005). Fluvastatin use was associated with reduction in cardiac death or nonfatal myocardial infarction, which achieved statistical significance in many subgroups. The subgroups included patients at lower cardiovascular risk, who were younger, nondiabetic, nonsmokers and without pre-existing CVD. These data support the early introduction of statins following renal transplantation.

By the author/editor: Jardine, Alan G.; Holdaas, Hallvar ...; Fellström, Bengt; Cole, Edward; Nyberg, Gudrun; Grönhagen-Riska, ...; show more...; Madsen, Sören; Neumayer, Hans-H ...; Maes, Bart; Ambühl, Patrice; Olsson, Anders, ...; Holme, Ingar; Fauchald, Per; Gimpelwicz, Clau ...; Pedersen, Terje ...; show less...

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