The statin use in patients on hemodialysis remains controversial, and no beneficial effects of statin on the reduction of adverse cardiovascular events have been reported in these patients. This study used stratification analysis to examine the clinical factors in patients on hemodialysis who could benefit from statin for secondary prevention. This prospective multicenter study included 234 consecutive patients on hemodialysis with coronary artery disease who underwent successful reperfusion therapy with percutaneous coronary intervention. The patients were followed up for up to 3 years or until the occurrence of major adverse cardiac events (MACEs; defined as a composite of all-cause death and nonfatal myocardial infarction). Inverse probability of treatment weighting adjustment was used to remove the selection bias. During the median follow-up period of 30 months, MACEs occurred in 55 patients. Patients with MACEs had significantly lower statin therapy (P < 0.001). Multivariable Cox proportional hazards analysis showed that the patients on statins had a significantly reduced rate of MACE occurrence [adjusted hazard ratio 0.30 (0.11–0.81), P = 0.02]. The stratification analysis of outcomes according to the presence of clinical factors showed that beneficial effects of statin were associated with man, elderly, lower body mass index, lower abdominal circumference, hypertension, diabetes, higher C-reactive protein, symptomatic heart failure, lower left ventricular function, nonacute coronary syndrome, and shorter stent length. Statin was effective for the prevention of MACEs in patients on hemodialysis who underwent percutaneous coronary intervention. We identified specific clinical factors affecting statin effectiveness for secondary prevention.

他汀类药物在血液透析患者中​​的使用仍存在争议，并且尚未报道他汀类药物对减少这些患者不良心血管事件的有益作用。本研究采用分层分析来检查血液透析患者可从他汀类药物二级预防中获益的临床因素。这项前瞻性多中心研究纳入了 234 名连续接受血液透析的冠状动脉疾病患者，他们接受了经皮冠状动脉介入治疗的成功再灌注治疗。对患者进行长达 3 年的随访，或直到发生主要不良心脏事件（MACE；定义为全因死亡和非致命性心肌梗死的复合事件）。使用治疗权重调整的逆概率来消除选择偏差。在中位随访 30 个月期间，55 名患者发生 MACE。患有 MACE 的患者他汀类药物治疗量显着较低( P < 0.001)。多变量Cox比例风险分析显示，服用他汀类药物的患者MACE发生率显着降低[调整后的风险比0.30（0.11-0.81），P = 0.02]。根据临床因素对结果进行分层分析表明，他汀类药物的有益效果与男性、老年人、较低的体重指数、较低的腹围、高血压、糖尿病、较高的 C 反应蛋白、有症状的心力衰竭、左下心室功能、非急性冠状动脉综合征和较短的支架长度。他汀类药物可有效预防接受经皮冠状动脉介入治疗的血液透析患者的 MACE。我们确定了影响他汀类药物二级预防有效性的具体临床因素。