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document
Relation of improvement in estimated glomerular filtration rate with atorvastatin to reductions in hospitalizations for heart failure ( from the Treating to New Targets [ TNT ] study ) . Impaired kidney function often accompanies heart failure ( HF ) and is associated with a worse prognosis . This post hoc analysis of the Treating to New Targets ( TNT ) trial examined whether the observed decrease in HF hospitalizations with high- compared to low-dose atorvastatin could be related to improvements in kidney function . Of 10,001 TNT participants , 9,376 had estimated glomerular filtration rate ( eGFR ) measurements at baseline and 1 year and were included in this analysis . The association of change in year-1 eGFR and subsequent HF hospitalization was examined using Cox regression models . In total 218 participants developed subsequent HF hospitalization . Little change in eGFR occurred over 1 year in the atorvastatin 10-mg group , whereas eGFR improved in the 80-mg group by 1.48 ml/min/1.73 m ( 2 ) ( 95 % confidence interval 1.29 to 1.67 , p < 0.0001 ) . Subsequent HF was preceded by a decrease in eGFR over 1 year compared to modest improvement in those without subsequent HF ( -0.09 ± 7.89 vs 0.81 ± 6.90 ml/min/1.73 m ( 2 ) , p = 0.0015 ) . After adjusting for baseline eGFR , each 5-ml/min/1.73 m ( 2 ) increase in eGFR at 1 year was associated with a lower risk of subsequent HF hospitalization ( hazard ratio 0.85 , 95 % confidence interval 0.77 to 0.94 , p = 0.002 ) . This relation was independent of treatment effect or change in low-density lipoprotein cholesterol level at 1 year . In conclusion , treatment with high- compared to low-dose atorvastatin was associated with improvement in eGFR at 1 year , which was related to a decrease in subsequent HF hospitalization . This suggests that improvement in kidney function may be related to the beneficial effect of high-dose atorvastatin on HF hospitalization .
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Intervention_Pharmacological
atorvastatin
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Intervention_Pharmacological
atorvastatin
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Outcome_Physical
eGFR
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Participant_Condition
Treating to New Targets [ TNT ] study )