Efeito das estatinas na progressão da calcificação coronariana em receptores de transplante renal

• Ano de defesa: 2017
• Autor(a) principal: Yazbek, Daniel Constantino [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/48912/0013000029154
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Statins; Coronary calcification; Kidney transplant recipients; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Kidney transplantation; Transplant recipients; Toxicology; Neurodegenerative diseases; Manganese; Comportamento de danio rerio; Manganês; Toxicologia; Doenças neurodegenerativas; Inibidores de hidroximetilglutaril-CoA redutases; Calcificação vascular; Transplante de rim; Transplantados; Complexos de manganês
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5746337; http://repositorio.unifesp.br/handle/11600/50628

Background: coronary artery calcification (CAC) is highly prevalent in kidney transplant recipients (KTRs) and has been associated with cardiovascular morbidity and mortality. Some studies have shown a reduction in CAC progression with statin therapy in the general and chronic kidney disease (CKD) populations. However, in kidney transplant there are no studies evaluating the impact of statin on cardiovascular disease. Objectives and Methods: the aim of the present study was to evaluate the effect of statins on CAC progression in incident kidney transplant recipients. A total of 100 incident renal transplant recipients were analyzed, mostly male (56%), aged 41.1 ± 37.6 years, with prior dialysis time 24 (11-60) months and most of them received a kidney for a living donors ( 67%). Patients were randomly assigned to the statin (n = 61, 10 mg daily with rosuvastatin or atorvastatin) and control group (n = 59). Coronary tomography scan and biochemical analyses were performed at baseline and 12 months. Results: at baseline, CAC was observed in 30% and 21% of patients in the statin and control groups, respectively (p = 0.39). The calcium score at baseline and its absolute and relative changes over 12 months of follow up were similar among the groups. In the statin group, total cholesterol (p < 0.001), low density lipoprotein cholesterol (p < 0.001) and triglycerides (p = 0.005) decreased, and the estimated glomerular function rate increased (p<0.001) significantly. CRP levels remained stable (p = 0.52) in the statin group but increased in the control group (p = 0.01). In the multivariate model, there was no difference in CAC progression between the groups (group effect p = 0.034; time-effect p = 0.23; interaction p = 0.74). Similar results were obtained when only calcified patients (calcium score > 10AU) were analyzed (group effect p = 0.051; time-effect p = 0.58; interaction p = 0.99). Conclusion: although statins reduce the levels of cholesterol, triglycerides, inflammation and improve graft function, the dose adopted in the current study did not delay CAC progression within 12 months of follow up.