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Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort

BACKGROUND: There are limited studies on the effects of statins on outcomes in the moderate chronic kidney disease (CKD) population and their trajectory to end-stage kidney disease. OBJECTIVE: To examine the long-term effects of lipid-lowering therapy on all-cause mortality, cardiovascular morbidity...

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Autores principales: Sukkar, Louisa, Talbot, Ben, Jun, Min, Dempsey, Erika, Walker, Robert, Hooi, Lai, Cass, Alan, Jardine, Meg, Gallagher, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794650/
https://www.ncbi.nlm.nih.gov/pubmed/31662874
http://dx.doi.org/10.1177/2054358119879896
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author Sukkar, Louisa
Talbot, Ben
Jun, Min
Dempsey, Erika
Walker, Robert
Hooi, Lai
Cass, Alan
Jardine, Meg
Gallagher, Martin
author_facet Sukkar, Louisa
Talbot, Ben
Jun, Min
Dempsey, Erika
Walker, Robert
Hooi, Lai
Cass, Alan
Jardine, Meg
Gallagher, Martin
author_sort Sukkar, Louisa
collection PubMed
description BACKGROUND: There are limited studies on the effects of statins on outcomes in the moderate chronic kidney disease (CKD) population and their trajectory to end-stage kidney disease. OBJECTIVE: To examine the long-term effects of lipid-lowering therapy on all-cause mortality, cardiovascular morbidity, CKD progression, and socioeconomic well-being in Australian, New Zealand, and Malaysian SHARP (Study of Heart and Renal Protection) trial participants—a randomized controlled trial of a combination of simvastatin and ezetimibe, compared with placebo, for the reduction of cardiovascular events in moderate to severe CKD. DESIGN: Protocol for an extended prospective observational follow-up. SETTING: Australian, New Zealand, and Malaysian participating centers in patients with advanced CKD. PATIENTS: All SHARP trial participants alive at the final study visit. MEASUREMENTS: Primary outcomes were measured by participant self-report and verified by hospital administrative data. In addition, secondary outcomes were measured using a validated study questionnaire of health-related quality of life, a 56-item economic survey. METHODS: Participants were followed up with alternating face-to-face visits and telephone calls on a 6-monthly basis until 5 years following their final SHARP Study visit. In addition, there were 6-monthly follow-up telephone calls in between these visits. Data linkage to health registries in Australia, New Zealand, and Malaysia was also performed. RESULTS: The SHARP-Extended Review (SHARP-ER) cohort comprised 1136 SHARP participants with a median of 4.6 years of follow-up. Compared with all SHARP participants who originally participated in the Australian, New Zealand, and Malaysian regions, the SHARP-ER participants were younger (57.2 [48.3-66.4] vs 60.5 [50.3-70.7] years) with a lower proportion of men (61.5% vs 62.8%). There were a lower proportion of participants with hypertension (83.7% vs 85.0%) and diabetes (20.0% vs 23.5%). LIMITATIONS: As a long-term follow-up study, the surviving cohort of SHARP-ER is a selected group of the original study participants, which may limit the generalizability of the findings. CONCLUSION: The SHARP-ER study will contribute important evidence on the long-term outcomes of cholesterol-lowering therapy in patients with advanced CKD with a total of 10 years of follow-up. Novel analyses of the socioeconomic impact of CKD over time will guide resource allocation. TRIAL REGISTRATION: The SHARP trial was registered at ClinicalTrials.gov NCT00125593 and ISRCTN 54137607.
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spelling pubmed-67946502019-10-29 Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort Sukkar, Louisa Talbot, Ben Jun, Min Dempsey, Erika Walker, Robert Hooi, Lai Cass, Alan Jardine, Meg Gallagher, Martin Can J Kidney Health Dis Study Protocol BACKGROUND: There are limited studies on the effects of statins on outcomes in the moderate chronic kidney disease (CKD) population and their trajectory to end-stage kidney disease. OBJECTIVE: To examine the long-term effects of lipid-lowering therapy on all-cause mortality, cardiovascular morbidity, CKD progression, and socioeconomic well-being in Australian, New Zealand, and Malaysian SHARP (Study of Heart and Renal Protection) trial participants—a randomized controlled trial of a combination of simvastatin and ezetimibe, compared with placebo, for the reduction of cardiovascular events in moderate to severe CKD. DESIGN: Protocol for an extended prospective observational follow-up. SETTING: Australian, New Zealand, and Malaysian participating centers in patients with advanced CKD. PATIENTS: All SHARP trial participants alive at the final study visit. MEASUREMENTS: Primary outcomes were measured by participant self-report and verified by hospital administrative data. In addition, secondary outcomes were measured using a validated study questionnaire of health-related quality of life, a 56-item economic survey. METHODS: Participants were followed up with alternating face-to-face visits and telephone calls on a 6-monthly basis until 5 years following their final SHARP Study visit. In addition, there were 6-monthly follow-up telephone calls in between these visits. Data linkage to health registries in Australia, New Zealand, and Malaysia was also performed. RESULTS: The SHARP-Extended Review (SHARP-ER) cohort comprised 1136 SHARP participants with a median of 4.6 years of follow-up. Compared with all SHARP participants who originally participated in the Australian, New Zealand, and Malaysian regions, the SHARP-ER participants were younger (57.2 [48.3-66.4] vs 60.5 [50.3-70.7] years) with a lower proportion of men (61.5% vs 62.8%). There were a lower proportion of participants with hypertension (83.7% vs 85.0%) and diabetes (20.0% vs 23.5%). LIMITATIONS: As a long-term follow-up study, the surviving cohort of SHARP-ER is a selected group of the original study participants, which may limit the generalizability of the findings. CONCLUSION: The SHARP-ER study will contribute important evidence on the long-term outcomes of cholesterol-lowering therapy in patients with advanced CKD with a total of 10 years of follow-up. Novel analyses of the socioeconomic impact of CKD over time will guide resource allocation. TRIAL REGISTRATION: The SHARP trial was registered at ClinicalTrials.gov NCT00125593 and ISRCTN 54137607. SAGE Publications 2019-10-14 /pmc/articles/PMC6794650/ /pubmed/31662874 http://dx.doi.org/10.1177/2054358119879896 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Study Protocol
Sukkar, Louisa
Talbot, Ben
Jun, Min
Dempsey, Erika
Walker, Robert
Hooi, Lai
Cass, Alan
Jardine, Meg
Gallagher, Martin
Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort
title Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort
title_full Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort
title_fullStr Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort
title_full_unstemmed Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort
title_short Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort
title_sort protocol for the study of heart and renal protection-extended review: additional 5-year follow-up of the australian, new zealand, and malaysian sharp cohort
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794650/
https://www.ncbi.nlm.nih.gov/pubmed/31662874
http://dx.doi.org/10.1177/2054358119879896
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