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Fluvastatin prevents cardiac death and myocardial infarction in renal transplant recipients: Post-hoc subgroup analyses of the ALERT study
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
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2004 (English)In: American Journal of Transplantation, ISSN 1600-6135, Vol. 4, no 6, 988-995 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2004. Vol. 4, no 6, 988-995 p.
Keyword [en]
ALERT, cardiac outcomes, fluvastatin, hypercholesterolemia, renal transplant recipients, statins
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-23706DOI: 10.1111/j.1600-6143.2004.00445.xLocal ID: 3207OAI: diva2:244021
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2011-01-12

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Olsson, Anders
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Faculty of Health SciencesInternal MedicineDepartment of Endocrinology and Gastroenterology UHL
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