Statin-Induced Increase in HDL-C and Renal Function in Coronary Heart Disease Patients§ Alternate Title: Statins, HDL-C, and Renal Function
Vasilios G Athyros*, 1, Anna I Kakafika1, Athanasios A Papageorgiou1, Efstathios D Pagourelias1, Savvas D Savvatianos1, Moses Elisaf2, Asterios Karagiannis1, Konstantinos Tziomalos1, 3, Dimitri P Mikhailidis3
Identifiers and Pagination:Year: 2007
First Page: 8
Last Page: 14
Publisher Id: TOCMJ-1-8
Article History:Received Date: 6/6/2007
Revision Received Date: 21/6/2007
Acceptance Date: 22/6/2007
Electronic publication date: 28/7/2007
Collection year: 2007
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Little is known about the potential of statin-induced high-density lipoprotein cholesterol (HDL-C) increase to improve renal function in coronary heart disease (CHD) patients.
Methods and Results: In this post hoc analysis of the GREek Atorvastatin and Coronary heart disease Evaluation (GREACE) Study we investigated the effect of HDL-C increase after statin treatment on renal function. From a total of 1,600 patients, 880 were on various statins (mainly atorvastatin) and 720 were not. Other secondary prevention therapies were similar in the 2 groups. After a 3 year follow up, the lipid profile was unchanged in the statin untreated group and estimated glomerular filtration rate (eGFR) was reduced by 5.1% compared with baseline (P<0.0001). In contrast, in the statin treated group non-HDL-C was reduced by 43%, HDL-C was increased by 7% and there was a significant increase in eGFR compared with baseline by 9.8% (P<0.0001). In multiple regression analysis, the mean 7% increase in HDL-C in the treated arm during the entire study was associated with a 5.6% increase in eGFR recorded after the 6th week of treatment. The odds ratio of eGFR increase with every 5% statin-induced rise in HDL-C was 1.78 (95% confidence interval 1.19-3.34; P=0.001).
Conclusions: Statin treatment significantly improved renal function. Statin-induced HDL-C increase significantly and independently contributed to this improvement. This finding supports the concept that improving lipid variables other than low density lipoprotein cholesterol is also beneficial to preserving renal function.