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High cholesterol absorption is associated with increased cardiovascular risk in haemodialysis patients: insights from the AURORA study

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  • معلومة اضافية
    • Contributors:
      Universität Graz = University of Graz; Medical University of Graz = Medizinische Universität Graz; Défaillance Cardiovasculaire Aiguë et Chronique (DCAC); Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL); Centre d'investigation clinique plurithématique Pierre Drouin Nancy (CIC-P); Centre d'investigation clinique Nancy (CIC); Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL); Cardiovascular and Renal Clinical Trialists Vandoeuvre-les-Nancy (INI-CRCT); Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu Nancy; French-Clinical Research Infrastructure Network - F-CRIN Paris (Cardiovascular & Renal Clinical Trialists - CRCT); University Hospital Mannheim; Universität Heidelberg Heidelberg = Heidelberg University; Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim; Universitätsklinikum Erlangen Erlangen; British Heart Foundation Glasgow Cardiovascular Research Centre (BHF GCRC); University of Glasgow-NHS Greater Glasgow & Clyde Glasgow (NHSGGC); Institute of Cardiovascular and Medical Sciences Glasgow; University of Glasgow; Centre de recherche en épidémiologie et santé des populations (CESP); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse; AP-HP. Université Paris Saclay-AP-HP. Université Paris Saclay-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay; Hôpital Ambroise Paré AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Uppsala University Hospital; The AURORA trial was sponsored by Astra-Zeneca. PR, FZ, KD are supported by the French PIA project “Lorraine Université d’Excellence” (reference: ANR-15-IDEX-04-LUE), Contrat de Plan Etat Lorraine IT2MP and FEDER Lorraine; ANR-15-IDEX-0004,LUE,Isite LUE(2015)
    • بيانات النشر:
      CCSD
      Sage Publications
    • الموضوع:
      2022
    • Collection:
      Université de Versailles Saint-Quentin-en-Yvelines: HAL-UVSQ
    • نبذة مختصرة :
      International audience ; Aims: Statin treatment did not reduce the risk of cardiovascular events in haemodialysis patients in the 4D and AURORA trials. Post hoc analyses in the 4D study suggested that high cholesterol absorption was associated with increased cardiovascular risk and that atorvastatin would reduce cardiovascular risk in haemodialysis patients with low cholesterol absorption but not in those with high cholesterol absorption.Methods and results: AURORA is a randomized, double-blind, placebo-controlled, multi-centre trial in haemodialysis patients. The participants were randomly assigned to receive either rosuvastatin, 10 mg daily, or a matching placebo. There was a follow-up for cardiovascular death with a median duration of 3.9 years. The cholestanol and lathosterol to cholesterol ratios were used to estimate cholesterol absorption and synthesis, respectively. Measurement of non-cholesterol sterols was available in 2332 participants of the 2733 patients included in the primary analysis of the AURORA study. A total of 598 participants died from cardiovascular diseases. The 3rd vs. the 1st tertile of the cholestanol-to-cholesterol ratio was significantly associated with increased risk of cardiovascular death [hazard ratio, HR (95% confidence interval, CI) = 1.36 (1.11-1.65)] in univariate (P = 0.002) and multivariate models (P = 0.034). In contrast, the 3rd vs. the 1st tertile of the lathosterol-to-cholesterol ratio was significantly associated with decreased risk of cardiovascular death [HR (95% CI) = 0.81 (0.67-0.99)] in univariate (P = 0.041) and multivariate (P = 0.019) models. There was no significant interaction between the cholestanol and lathosterol to cholesterol tertiles and treatment group in predicting cardiovascular death.Conclusion: The present data from the AURORA study confirm that high cholesterol absorption is associated with increased cardiovascular risk in haemodialysis patients. Assessment of the individual cholesterol absorption rate to guide initiation of statin treatment is ...
    • Relation:
      info:eu-repo/semantics/altIdentifier/pmid/35512252; PUBMED: 35512252
    • الرقم المعرف:
      10.1093/eurjpc/zwac059
    • الدخول الالكتروني :
      https://hal.univ-lorraine.fr/hal-03800955
      https://hal.univ-lorraine.fr/hal-03800955v1/document
      https://hal.univ-lorraine.fr/hal-03800955v1/file/EJPC-D-21-01903_R2.pdf
      https://doi.org/10.1093/eurjpc/zwac059
    • Rights:
      info:eu-repo/semantics/OpenAccess
    • الرقم المعرف:
      edsbas.B859467C