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Atorvastatin Helps Protect Kidneys in SPARCL Patients: Presented at AHA

By Ed Susman

ORLANDO, FL -- November 12, 2007 -- Treatment of stroke patients with atorvastatin can preserve kidney function in patients with or without chronic kidney disease, metabolic syndrome, or type 2 diabetes, researchers reported here at the American Heart Association (AHA) 2007 Scientific Sessions.

In a new post hoc analysis of the Stroke Prevention by Aggressive Reduction of Cholesterol Levels (SPARCL) study, doctors scrutinized kidney function based on the glomerular filtration rate (GFR), a standard test of global kidney function.

Poststroke or mini-stroke patients without chronic kidney disease, with chronic kidney disease, and with metabolic syndrome who were treated with atorvastatin 80 mg demonstrated improved kidney function compared with placebo, the researchers said on November 5.

"These results are especially significant for poststroke diabetic patients because they are more likely to develop progressive kidney disease," said Vito Campese, MD, Chief, Division of Nephrology/Hypertension, University of Southern California, Los Angeles, California.

"With atorvastatin we were able to stabilize patients' kidney function, and given the established relationship between progressive kidney disease and cardiovascular outcome, this may contribute to reducing cardiovascular events," he added.

Among the 2,671 patients without chronic kidney disease, atorvastatin 80 mg significantly improved kidney function compared with placebo, changing the estimated glomerular filtration rate (GFR) during the trial by 2.22 mL/min/1.73 m² versus 0.22 mL/min/1.73m² (P <.0001).

In addition, patients with chronic kidney disease had an increase in GFR of 3.15 mL/min/1.73m² with atorvastatin compared with 1.82 mL/min/1.73 m² with placebo (P =.017).

The atorvastatin arm of the study also saw improvement or stabilization of kidney function in patients with metabolic syndrome and in patients with type 2 diabetes, Dr. Campese said.

The original SPARCL study, which enrolled 4,731 patients, was published in 2006 (N Engl J Med. 2006;355(6):549-59). The trial is the only study to date to evaluate the benefits of a statin solely in patients with a prior stroke or mini-stroke.

In the SPARCL study, patients with chronic kidney disease had higher risk of stroke (27%) or major coronary events (70%) compared with patients without chronic kidney disease. In the trial, those with kidney disease significantly reduced their risk of major coronary events by taking atorvastatin.

In a previous post hoc analysis of the SPARCL trial, there was a higher incidence of hemorrhagic stroke in patients taking atorvastatin 80 mg compared with patients taking placebo. Patients with prior hemorrhagic stroke at study entry appeared to be at an increased risk of hemorrhagic stroke.

Funding for the SPARCL trial was provided by Pfizer.


[Presentation title: Effect of High-Dose Atorvastatin on Changes in Renal Function: A Secondary Analysis of the Stroke Prevention by Aggressive Reduction of Cholesterol Levels (SPARCL) Trial. Abstract 2173]

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