Statin Use and Incidence of Chronic Kidney Disease in Hypercholesterolemia Patients with Normal Renal Function

<b><i>Introduction:</i></b> Dyslipidemia is a known risk factor for chronic kidney disease (CKD). The effects of statins on CKD have already been studied in patients with CKD; however, data on the general population are limited. This study aimed to determine the relationship between statin use and the incidence of CKD in patients with hypercholesterolemia having normal renal function. <b><i>Methods:</i></b> A total of 7,856 participants aged 40–79 years at baseline (2009–2010) were included in the final analyses. The participants were divided into statin users (<i>n</i> = 4,168) and statin nonusers (<i>n</i> = 3,668), according to the statin usage. The Cox proportional hazard regression model was used to evaluate the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for CKD. <b><i>Results:</i></b> The median follow-up duration was 5.8 years. A total of 543 cases of CKD (285 cases in males and 258 cases in females) occurred during the study period. The estimated cumulative incidence of CKD was significantly different between male statin nonusers and users (<i>p</i> &#x3c; 0.001), while it was not statistically significant between female statin nonusers and users (<i>p</i> = 0.126). Compared with statin nonusers, the fully adjusted HRs (95% CIs) for CKD in statin users were 1.014 (0.773–1.330) in males and 1.117 (0.843–1.481) in females. <b><i>Conclusion:</i></b> Dyslipidemia is an obvious risk factor for CKD; however, statin use in patients with hypercholesterolemia having normal renal function does not demonstrate a clear relationship with the incidence of CKD.

The protective association between statins use and adverse outcomes among COVID-19 patients: A systematic review and meta-analysis

Introduction Statins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage. Methods Literatures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately. Results Thirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88). Conclusion Patients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

Correction to: Reduced oxidized LDL in T2D plaques is associated with a greater statin usage but not with future cardiovascular events

An amendment to this paper has been published and can be accessed via the original article.

The protective association between statins use and adverse outcomes among COVID-19 patients: a systematic review and meta-analysis

ABSTRACTIntroductionStatins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage.MethodsLiteratures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately.ResultsThirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88).ConclusionPatients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

Reduced oxidized LDL in T2D plaques is associated with a greater statin usage but not with future cardiovascular events

Background Type 2 diabetes (T2D) patients are at a greater risk of cardiovascular events due to aggravated atherosclerosis. Oxidized LDL (oxLDL) has been shown to be increased in T2D plaques and suggested to contribute to plaque ruptures. Despite intensified statin treatment during the last decade the higher risk for events remains. Here, we explored if intensified statin treatment was associated with reduced oxLDL in T2D plaques and if oxLDL predicts cardiovascular events, to elucidate whether further plaque oxLDL reduction would be a promising therapeutic target. Methods Carotid plaque OxLDL levels and plasma lipoproteins were assessed in 200 patients. Plaque oxLDL was located by immunohistochemistry. Plaque cytokines, cells and scavenger receptor gene expression were quantified by Luminex, immunohistochemistry and RNA sequencing, respectively. Clinical information and events during follow-up were obtained from national registers. Results Plaque oxLDL levels correlated with markers of inflammatory activity, endothelial activation and plasma LDL cholesterol (r = 0.22-0.32 and p ≤ 0.01 for all). T2D individuals exhibited lower plaque levels of oxLDL, sLOX-1(a marker of endothelial activation) and plasma LDL cholesterol (p = 0.001, p = 0.006 and p = 0.009). No increased gene expression of scavenger receptors was identified in T2D plaques. The lower oxLDL content in T2D plaques was associated with a greater statin usage (p = 0.026). Supporting this, a linear regression model showed that statin treatment was the factor with the strongest association to plaque oxLDL and plasma LDL cholesterol (p < 0.001 for both). However, patients with T2D more frequently suffered from symptoms and yet plaque levels of oxLDL did not predict cardiovascular events in T2D (findings are summarized in Fig. 1a). Conclusions This study points out the importance of statin treatment in affecting plaque biology in T2D. It also implies that other biological components, beyond oxLDL, need to be identified and targeted to further reduce the risk of events among T2D patients receiving statin treatment.