ArticleClinical kidney journal2023
Recurrent cardiovascular events in patients with type 2 diabetes and haemodialysis: analysis from the 4D Study.
Article in Clinical kidney journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mortality and Cardiovascular Outcomes Associated with Statin Use in Dialysis Patients with Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis.Kidney & blood pressure research · 2026Pooled it
- Target trial emulation of sodium glucose cotransporter 2 inhibitors and clinical outcomes in diabetes and end stage kidney disease.Scientific reports · 2026Article
- Interpreting the PISCES trial on fish oil in hemodialysis patients: lessons on trial design, biological exposure, and outcome measurement.Clinical kidney journal · 2026Review
- Analyzing recurrent events in multiple sclerosis: a review of statistical models with application to the MSOAC database.Journal of neurology · 2025Review
- Lifelong statins for long life in dialysis patients?Clinical kidney journal · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In the 'Die Deutsche Diabetes Dialyse Studie' (4D Study), treatment of patients with type 2 diabetes mellitus (T2DM) on haemodialysis (HD) with atorvastatin compared with placebo had no significant effect on the first composite primary major adverse cardiovascular event (MACE) endpoint of death from cardiac causes, fatal stroke, non-fatal myocardial infarction or non-fatal stroke. In this study we analysed first and recurrent events in 1255 patients from the 4D Study. Methods: We conducted an event history analysis to investigate the effects of previous clinical events on the risk of different endpoints in the total patient group and after stratification by randomization group. Results: During a median follow-up of 4 years, a total of 548 MACEs occurred, with 469 first and 79 recurrent events. The most frequent event was sudden cardiac death, followed by death due to infection/sepsis. Of the 548 total MACEs, 260 occurred in the atorvastatin group and 288 in the placebo group [hazard ratio 0.91 (95% confidence interval 0.76-1.07), Conclusion: This recurrent and total event analysis from the 4D Study underscores the high risk of sudden cardiac death and death due to infection/sepsis in patients with T2DM receiving HD and raises the hypothesis that atorvastatin may stabilize cardiovascular risk only after 1-2 years in this high-risk population.
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