PMID- 24786143
OWN - NLM
STAT- MEDLINE
DCOM- 20150224
LR  - 20211021
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 3
IP  - 3
DP  - 2014 May 1
TI  - The incidence of kidney injury for patients treated with a high-potency versus 
      moderate-potency statin regimen after an acute coronary syndrome.
PG  - e000784
LID - 10.1161/JAHA.114.000784 [doi]
LID - e000784
AB  - BACKGROUND: Observational studies have raised concerns that high-potency statins 
      increase the risk of acute kidney injury. We therefore examined the incidence of 
      kidney injury across 2 randomized trials of statin therapy. METHODS AND RESULTS: 
      PROVE IT-TIMI 22 enrolled 4162 subjects after an acute coronary syndrome (ACS) 
      and randomized them to atorvastatin 80 mg/day versus pravastatin 40 mg/day. 
      A-to-Z enrolled 4497 subjects after ACS and randomized them to a high-potency 
      (simvastatin 40 mg/day x 1 months, then simvastatin 80 mg/day) versus a delayed 
      moderate-potency statin strategy (placebo x 4 months, then simvastatin 20 
      mg/day). Serum creatinine was assessed centrally at serial time points. Adverse 
      events (AEs) relating to kidney injury were identified through database review. 
      Across both trials, mean serum creatinine was similar between treatment arms at 
      baseline and throughout follow-up. In A-to-Z, the incidence of a 1.5-fold or >/= 
      0.3 mg/dL rise in serum creatinine was 11.4% for subjects randomized to a 
      high-potency statin regimen versus 12.4% for those on a delayed moderate-potency 
      regimen (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.76 to 1.10; 
      P=0.33). In PROVE IT-TIMI 22, the incidence was 9.4% for subjects randomized to 
      atorvastatin 80 mg/day and 10.6% for subjects randomized to pravastatin 40 mg/day 
      (OR, 0.88; 95% CI, 0.71 to 1.09; P=0.25). Consistent results were observed for 
      different kidney injury thresholds and in individuals with diabetes mellitus or 
      with moderate renal dysfunction. The incidence of kidney injury-related adverse 
      events (AEs) was not statistically different for patients on a high-potency 
      versus moderate-potency statin regimen (OR, 1.06; 95% CI, 0.68 to 1.67; P=0.78). 
      CONCLUSIONS: For patients enrolled in 2 large randomized trials of statin therapy 
      after ACS, the use of a high-potency statin regimen did not increase the risk of 
      kidney injury.
FAU - Sarma, Amy
AU  - Sarma A
AD  - Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
FAU - Cannon, Christopher P
AU  - Cannon CP
FAU - de Lemos, James
AU  - de Lemos J
FAU - Rouleau, Jean L
AU  - Rouleau JL
FAU - Lewis, Eldrin F
AU  - Lewis EF
FAU - Guo, Jianping
AU  - Guo J
FAU - Mega, Jessica L
AU  - Mega JL
FAU - Sabatine, Marc S
AU  - Sabatine MS
FAU - O'Donoghue, Michelle L
AU  - O'Donoghue ML
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20140501
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
RN  - 0 (Heptanoic Acids)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Pyrroles)
RN  - A0JWA85V8F (Atorvastatin)
RN  - AYI8EX34EU (Creatinine)
RN  - KXO2KT9N0G (Pravastatin)
SB  - IM
MH  - Acute Coronary Syndrome/*drug therapy
MH  - Acute Kidney Injury/*chemically induced/epidemiology
MH  - Atorvastatin
MH  - Creatinine/blood
MH  - Double-Blind Method
MH  - Drug Administration Schedule
MH  - Female
MH  - Heptanoic Acids/administration & dosage/*adverse effects/therapeutic use
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage/*adverse 
      effects/therapeutic use
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Pravastatin/administration & dosage/*adverse effects/therapeutic use
MH  - Pyrroles/administration & dosage/*adverse effects/therapeutic use
PMC - PMC4309063
OTO - NOTNLM
OT  - acute coronary syndrome
OT  - acute kidney injury
OT  - kidney
OT  - statins
EDAT- 2014/05/03 06:00
MHDA- 2015/02/25 06:00
PMCR- 2014/06/01
CRDT- 2014/05/03 06:00
PHST- 2014/05/03 06:00 [entrez]
PHST- 2014/05/03 06:00 [pubmed]
PHST- 2015/02/25 06:00 [medline]
PHST- 2014/06/01 00:00 [pmc-release]
AID - jah3524 [pii]
AID - 10.1161/JAHA.114.000784 [doi]
PST - epublish
SO  - J Am Heart Assoc. 2014 May 1;3(3):e000784. doi: 10.1161/JAHA.114.000784.