Is a treat-to-target approach to lipid-lowering therapy appropriate in patients with chronic kidney disease? A prospective French cohort study.
| dc.rights.license | open | en_US |
| dc.contributor.author | MASSY, Ziad A | |
| dc.contributor.author | KOLLA, Epiphane | |
| dc.contributor.author | FERRIÈRES, Jean | |
| dc.contributor.author | BRUCKERT, Eric | |
| dc.contributor.author | LAMBERT, Oriane | |
| dc.contributor.author | MANSENCAL, Nicolas | |
| dc.contributor.author | LAVILLE, Maurice | |
| dc.contributor.author | FRIMAT, Luc | |
| dc.contributor.author | FOUQUE, Denis | |
| hal.structure.identifier | Bioingénierie tissulaire [BIOTIS] | |
| dc.contributor.author | COMBE, Christian
ORCID: 0000-0002-0360-573X IDREF: 58708871 | |
| dc.contributor.author | PECOITS-FILHO, Roberto | |
| dc.contributor.author | STENGEL, Bénédicte | |
| dc.contributor.author | LIABEUF, Sophie | |
| dc.date.accessioned | 2021-12-21T09:11:23Z | |
| dc.date.available | 2021-12-21T09:11:23Z | |
| dc.date.issued | 2021-01-01 | |
| dc.identifier.issn | 1724-6059 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/124245 | |
| dc.description.abstractEn | Whereas European guidelines recommend adjusting lipid-lowering therapy (LLT) to meet prespecified targets ('treat-to-target') for low-density lipoprotein cholesterol (LDL-C), other guidelines do not ('fire and forget'). In a large observational prospective cohort, we sought to evaluate which strategy could be associated with better cardiovascular outcomes in chronic kidney disease (CKD). In CKD-REIN, patients (CKD stages 3 and 4) on LLT were categorized according to achievement of LDL-C targets for high and very high cardiovascular risk (< 2.6 and < 1.8 mmol/L, respectively) at baseline. Primary outcome was fatal/non-fatal atheromatous cardiovascular disease (CVD). Secondary outcomes were non-atheromatous CVD, atheromatous or non-atheromatous CVD, and major adverse cardiovascular events. The population comprised 1521 patients (68 ± 12 years, 31% women, mean estimated glomerular filtration rate [eGFR] 35 mL/min/1.73 m). Overall, 523 (34%) met their LDL-C targets at baseline. Median follow-up was 2.9 years (interquartile range 2.2-3.0). Incidence rates per 100 patient-years were 6.2% (95% confidence interval [CI] 5.5-7.0) for atheromatous CVD, 9.2% (8.3-10.1) for non-atheromatous CVD, 15.2% (14.0-16.4) for atheromatous/non-atheromatous CVD, and 6.3% (5.5-7.1) for major adverse cardiovascular events. Corresponding rates in patients who achieved targets were 6.6%, 9.8%, 16.1%, and 6.3%, respectively. Target achievement was not associated with risk of fatal/non-fatal atheromatous CVD (adjusted hazard ratio 1.04, 95% CI 0.76-1.44, p = 0.77) or fatal/non-fatal atheromatous or non-atheromatous CVD (0.98, 0.78-1.23, p = 0.91). These findings do not appear to support a treat-to-target approach in CKD patients on LLT, and may favor the hypothesis of an advantage of fire-and-forget. Randomized trials are needed to confirm this theory. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | Aged | |
| dc.subject.en | Aged | |
| dc.subject.en | 80 and over | |
| dc.subject.en | Cardiovascular Diseases | |
| dc.subject.en | Cholesterol | |
| dc.subject.en | LDL | |
| dc.subject.en | Female | |
| dc.subject.en | Humans | |
| dc.subject.en | Hyperlipidemias | |
| dc.subject.en | Hypolipidemic Agents | |
| dc.subject.en | Male | |
| dc.subject.en | Middle Aged | |
| dc.subject.en | Prospective Studies | |
| dc.subject.en | Renal Insufficiency | |
| dc.subject.en | Chronic | |
| dc.subject.en | Risk Factors | |
| dc.title.en | Is a treat-to-target approach to lipid-lowering therapy appropriate in patients with chronic kidney disease? A prospective French cohort study. | |
| dc.title.alternative | J Nephrol | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1007/s40620-021-01086-y | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Biotechnologies | en_US |
| dc.identifier.pubmed | 34117621 | en_US |
| bordeaux.journal | Journal of Nephrology | en_US |
| bordeaux.page | 1467-1477 | en_US |
| bordeaux.volume | 34 | en_US |
| bordeaux.hal.laboratories | Bioingénierie Tissulaire (BioTis) - UMR_S 1026 | en_US |
| bordeaux.issue | 5 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | CNRS | en_US |
| bordeaux.institution | INSERM | en_US |
| bordeaux.institution | CHU de Bordeaux | en_US |
| bordeaux.institution | Institut Bergonié | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| bordeaux.import.source | pubmed | |
| hal.identifier | inserm-03344399 | |
| hal.version | 1 | |
| hal.export | false | |
| workflow.import.source | pubmed | |
| dc.rights.cc | Pas de Licence CC | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal%20of%20Nephrology&rft.date=2021-01-01&rft.volume=34&rft.issue=5&rft.spage=1467-1477&rft.epage=1467-1477&rft.eissn=1724-6059&rft.issn=1724-6059&rft.au=MASSY,%20Ziad%20A&KOLLA,%20Epiphane&FERRI%C3%88RES,%20Jean&BRUCKERT,%20Eric&LAMBERT,%20Oriane&rft.genre=article |
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