Association between statin use and major adverse cardiovascular events in patients with chronic kidney disease and cardiomyopathy: A retrospective case-control study.

Statin use was significantly lower in patients who experienced MACE compared to controls in this CKD and cardiomyopathy population.

• Overall prevalence of statin use was 59.6% across all 765 patients
• Statin use was 48.2% in the case group versus 65.3% in controls (P < .001)
• Study included 255 cases and 510 controls from a single center, hospitalized between January 2016 and February 2025

Statin use was significantly associated with a reduced risk of MACE in univariate analysis.

• Unadjusted odds ratio = 0.52 (95% CI: 0.38–0.70, P < .001)
• Analysis was performed using univariate logistic regression prior to multivariable adjustment

MACE incidence decreased progressively with higher statin doses in a dose-response relationship.

• MACE incidence was 41.1% in nonusers, 28.7% in the low-to-moderate dose group, and 20.2% in the high-dose group
• P for trend = .002 across the three groups
• Patients were categorized according to atorvastatin-equivalent doses

Regular statin therapy remained independently associated with lower MACE risk after multivariable adjustment, with the strongest benefit in the high-dose group.

• Multivariable logistic regression adjusted for age, sex, body mass index, diabetes and hypertension control, eGFR, and β-blocker use
• High-dose group adjusted odds ratio = 0.47 (95% CI: 0.31–0.72, P = .001)
• Regular statin therapy as a whole remained independently associated with lower MACE risk after adjustment

The protective effect of statin therapy was consistent across CKD stages and cardiomyopathy etiologies.

• Subgroup analyses demonstrated consistent protective effects across CKD stages and cardiomyopathy etiologies (ischemic vs non-ischemic)
• P for interaction > .05 across subgroups, indicating no significant effect modification
• Analyses were performed using multivariable logistic regression with subgroup stratification

Statin treatment was generally well tolerated in this CKD and cardiomyopathy population with no serious adverse reactions observed.

• Only mild, reversible elevations in liver enzymes or muscle enzymes were reported
• No serious adverse reactions were observed
• Safety assessment was conducted in the context of a retrospective case-control design