Statin therapy associated mortality in hyperlipidemic dialysis patients with percutaneous coronary intervention for acute myocardial infarction, a retrospective cohort study.

Objective: Hyperlipidemic patients with end-stage renal disease (ESRD) are at a higher risk of death from cardiovascular diseases, especially from acute myocardial infarction (AMI). Studies on the efficacy of statin therapy (ST) in dialysis patients after percutaneous coronary intervention (PCI) are limited. We examine the mortality associated with ST for these patients. Methods: From dialysis-dependent hyperlipidemic patients with AMI and receiving PCI in the claims data of National Health Insurance of Taiwan in 2000-2016, we identified a cohort with ST and a cohort without ST matched by propensity score at a 1:1 ratio. Both cohorts were followed up until the end of 2017. All-cause mortalities were examined for both cohorts. Other factors associated with the deaths were also examined. Results: Among 2642 enrollees in each cohort, over 99 % had hypertension. The all-cause mortality was 23 % lower in the ST cohort than in non-ST cohort (10.8 versus 14.0 per 100 person-years) with an adjusted hazard ratio of 0.77(95 % confidence interval = 0.71-0.84). Patients with comorbidities of diabetes, cerebrovascular accident (CVA) and congestive heart failure (CHF) were also at lower risk. The case-control analysis in the ST cohort showed the estimated risk of death increased with age, and higher for females and patients with peripheral artery disease. Conclusions: The ST for hyperlipidemic patients with ESRD experiencing AMI undergoing PCI could be benefited with lower all-cause mortality, even for patients with diabetes, hypertension, CVA or CHF.