Cardiovascular therapeutics · 2026
Effect of Statin Use on Mortality in Individuals With Cardiovascular-Kidney-Metabolic Syndrome: A Retrospective Propensity Score-Matched Cohort Study.
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Yuan Cheng, Ge Yuguo, Ge Wenqi, Wang Huaxue, Deng Ximing, Chen Jinmeng, Niu Kaixuan, Xiong Jinhui, Xu Yang, Lu Kun
Аннотация
BACKGROUND: The present study is aimed at investigating the effects of statins on all-cause and cardiovascular mortalities in individuals with cardiovascular-kidney-metabolic syndrome (CKMS).
METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, we identified individuals with CKMS and categorized them into statin-treated and untreated groups based on statin exposure. A propensity score matching (PSM) model was applied to balance baseline characteristics between the two groups. All-cause and cardiovascular mortalities were then assessed.
RESULTS: A total of 19087 individuals with CKMS were enrolled, yielding 4762 matched individuals. Compared with the statin-untreated group, statin therapy was associated with significant mortality benefits in CKMS individuals, demonstrating a 27% reduction in all-cause mortality (HR 0.73, 95% CI 0.65-0.82) and a 26% decrease in cardiovascular mortality (HR 0.74, 95% CI 0.61-0.90). Stratified analyses by CKMS stage showed no significant interaction between disease stage and statin use for either all-cause (p for interaction = 0.81) or cardiovascular mortality (p for interaction = 0.13), although statistically significant inverse associations were primarily observed in individuals with advanced CKMS stages. Analyses by statin type indicated that atorvastatin and simvastatin were associated with reduced risks of both all-cause and cardiovascular mortalities, whereas rosuvastatin was associated with a reduced risk of all-cause mortality only. Exploratory subgroup analyses suggested that the associations were more evident among individuals with intermediate levels of total cholesterol (200-240 mg/dL) and LDL cholesterol (130-160 mg/dL).
CONCLUSION: In this nationally representative cohort, statin use was associated with lower risks of all-cause and cardiovascular mortalities among individuals with CKMS. These findings warrant confirmation in prospective studies with larger sample sizes to further clarify potential heterogeneity across statin type, disease stages, and different lipid profiles.
METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018, we identified individuals with CKMS and categorized them into statin-treated and untreated groups based on statin exposure. A propensity score matching (PSM) model was applied to balance baseline characteristics between the two groups. All-cause and cardiovascular mortalities were then assessed.
RESULTS: A total of 19087 individuals with CKMS were enrolled, yielding 4762 matched individuals. Compared with the statin-untreated group, statin therapy was associated with significant mortality benefits in CKMS individuals, demonstrating a 27% reduction in all-cause mortality (HR 0.73, 95% CI 0.65-0.82) and a 26% decrease in cardiovascular mortality (HR 0.74, 95% CI 0.61-0.90). Stratified analyses by CKMS stage showed no significant interaction between disease stage and statin use for either all-cause (p for interaction = 0.81) or cardiovascular mortality (p for interaction = 0.13), although statistically significant inverse associations were primarily observed in individuals with advanced CKMS stages. Analyses by statin type indicated that atorvastatin and simvastatin were associated with reduced risks of both all-cause and cardiovascular mortalities, whereas rosuvastatin was associated with a reduced risk of all-cause mortality only. Exploratory subgroup analyses suggested that the associations were more evident among individuals with intermediate levels of total cholesterol (200-240 mg/dL) and LDL cholesterol (130-160 mg/dL).
CONCLUSION: In this nationally representative cohort, statin use was associated with lower risks of all-cause and cardiovascular mortalities among individuals with CKMS. These findings warrant confirmation in prospective studies with larger sample sizes to further clarify potential heterogeneity across statin type, disease stages, and different lipid profiles.
Предметные рубрики MeSH
HumansHydroxymethylglutaryl-CoA Reductase InhibitorsCardiovascular DiseasesMaleMetabolic SyndromeFemaleRetrospective StudiesMiddle AgedRisk AssessmentTime FactorsAgedTreatment OutcomeNutrition SurveysUnited StatesKidney DiseasesCause of DeathAdultProtective FactorsDyslipidemiasPropensity ScoreRisk Factors