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논문분류	춘계학술대회 초록집
제목	Association of LDL-C with adverse clinical outcomes in Korean patients with chronic kidney disease: Results from KNOW-CKD
저자	Changhyun Lee, Tae-Ik Chang, Ea Wha Kang, Curie Ahn, Kook-Hwan Oh, Jung Tak Park, Tae-Hyun Yoo, Shin-Wook Kang, Seung Hyeok Han
출판정보	2020; 2020(1):
키워드	LDL-cholesterol \| mortality \| cardiovascular events \| kidney outcome
초록	Lowering low-density lipoprotein cholesterol (LDL-C) level is an important therapeutic strategy in patients with CKD. However, few studies have examined optimal level of LDL-C in these patients. We studied the association of LDL-C with adverse clinical outcomes in 1,975 patients from the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD). Patients were classified into four groups according to LDL-C level of <70, 70-99, 100-129, and ≥130 mg/dL. The primary outcome was an extended major cardiovascular events (eMACE), which was defined as non-fatal cardiovascular events, symptomatic arrhythmia, and cardiac death. The secondary endpoints included separate outcomes of composite renal outcome (≥50% decline in eGFR or the onset of end-stage renal disease), non-fatal MACE, and all-cause death. The mean LDL-C level was 97.2±31.4 mg/dL, and the mean eGFR was 53.3±30.9 ml/min/1.73 m2. During the mean follow-up of 4.1 years, the primary outcome events occurred in 110 (5.9%) patients with incidence rate of 14.6 per 1,000 person-years. In multivariable Cox analysis after adjustment of confounders, there was a graded association of LDL-C with the primary outcome. The HRs (95% CI) for the corresponding four LDL-C categories were 1.97 (1.06-3.68), 2.60 (1.16-5.82), and 3.30 (1.21-9.00), compared with LDL of <70 mg/dL. In the analyses of secondary outcomes, incidence rates for kidney outcome, non-fatal MACE, and all-cause death were 75.2, 14.2, and 9.5 per 1,000 person-years, respectively. There was a significant association of higher LDL-C level and risk of non-fatal MACE. However, LDL-C level was not associated with adverse kidney outcomes and all-cause mortality. In Korean CKD patients, LDL-C level was significantly associated with higher risk of MACE.
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