Atorvastatin Reduces Risk of MI and Stroke in Chronic Kidney Disease

A new study has found that an 80 mg dose of atorvastatin calcium reduced the risk of heart attack and stroke by a third in patients who have heart disease and chronic kidney disease, compared with patients taking the 10 mg dose.

Researchers at the University of Glasgow Medical School (UK) randomized 10,001 patients participating in the Treating to New Targets (TNT) study with CHD to double-blind therapy with atorvastatin 80 mg/day or 10 mg/day. Patients with pre-existing chronic kidney disease (CKD) were identified at baseline based on an estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m2. The efficacy results of the analysis were primarily driven by reductions in heart attack and stroke. The primary endpoint of the study was the reduction of major cardiovascular events, including death from heart disease, non-fatal heart attacks, resuscitated cardiac arrest, and fatal or non-fatal strokes.

The results showed that of the 9656 patients with complete renal data, 3107 had CKD at baseline and demonstrated greater cardiovascular comorbidity than those with normal eGFR. After a median follow-up of five years, 351 patients with CKD (11.3%) experienced a major cardiovascular event, compared with 561 patients with normal eGFR (8.6%). Compared with atorvastatin 10 mg, atorvastatin 80 mg reduced the relative risk of major cardiovascular events by 32% in patients with CKD and 15% in patients with normal eGFR. Both doses of atorvastatin were well tolerated in patients with CKD. The study was published in the April 15, 2008, issue of the Journal of the American College of Cardiology.

"People with chronic kidney disease are more likely to die from heart disease than to develop kidney failure,” said lead author James Shepherd, M.D., a member of the TNT steering committee and clinical academic consultant at the department of pathological biochemistry at Glasgow. "It is critical for us to find new ways to reduce cardiovascular burden in these patients. Intensive statin therapy seems to be at least part of the solution.”

Atorvastatin is a member of the drug class known as statins, used for lowering cholesterol. Atorvastatin inhibits the rate-determining enzyme located in hepatic tissue that produces mevalonate; a small molecule used in the synthesis of cholesterol and other mevalonate derivatives. This lowers the amount of cholesterol produced that in turn lowers the total amount of low-density lipoprotein (LDL) cholesterol. Atorvastatin is patented and marketed under the brand name Lipitor by Pfizer (New York, NY, USA).


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University of Glasgow Medical School
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