On vascular calcification prevention with phosphonoformate and bisphosphonates

recommended in the secondary prevention of acute coronary syndrome (ACS). To investigate the use of statins for the primary prevention of ACS, between April 2004 and February 2005 we enrolled a total of 31 end-stage renal disease patients on MHD, with neither history nor clinical and instrumental signs of earlier major adverse cardiac events (MACEs). We started each patient on atorvastatin (10 mg) daily regardless of serum low-density lipoprotein cholesterol associated with conventional pharmacologic control of blood pressure, serum glucose, and calcium–phosphate balance. During a 4-year follow-up overall 3-year actuarial survival was 67%, compared with a 20–40% 5-year survival reported earlier. Cardiovascular mortality was 12.9%, (4 patients). ‘MACE’ free’ (lethal and non-lethal) 3-year actuarial survival was 53%. Treatment with statins may be considered in the primary prevention of MACEs in hemodialysis patients.

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