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Halimat Ibrahim

Supervisor(s): Aminu Bello
Award:  KRESCENT Summer Studentship
Institution:  University of Alberta
Year: 2024

Project Title: Can Treatment with Lipid-lowering Medications Attenuate the Risk of Heart Attack and Stroke in patients undergoing chronic dialysis

Halimat Ibrahim is a dedicated healthcare professional with a profound commitment to advancing medical care. She has a rich background in pharmacy, having earned her Doctor of Pharmacy degree from the University of Alberta. She currently practices as a part-time pharmacist and is also a second-year medical student. Her research interests focus on chronic disease management, particularly in underserved communities, and she is passionate about developing innovative solutions to improve patient outcomes. Through her academic and professional journey, Halimat continues to strive towards making a meaningful impact in the field of healthcare.

Lay Summary
Background: Heart disease and strokes are major concerns for people undergoing dialysis, a treatment for severe kidney failure. Patients on dialysis have a significantly higher risk of serious medical conditions, such as heart attacks, stroke, and heart failure. This elevated risk is due to the combination of kidney disease and other health conditions that many patients on dialysis have, such as diabetes and high blood pressure. Statins, a type of medication used to lower lipids, are known to reduce heart-related events in the general population, but their effectiveness in patients on dialysis is still unclear. We therefore aim to determine if statins use can improve heart health, reduce stroke risk and enhanced longevity among patients receiving treatment for kidney failure with dialysis.

Purpose: The goal of our research is to investigate whether statin therapy can reduce major cardiovascular events, such as heart attacks and strokes, among adults undergoing chronic dialysis. By addressing this question, we hope to provide evidence that can guide healthcare providers, policymakers and patients on the utility of lipids-lowering therapy using statins among patients on chronic dialysis

Methods: To achieve our objective, we will conduct a retrospective cohort study using administrative database (obtained from routine healthcare encounters in Alberta). This means we will analyze past medical records of adults residing in Alberta who were on maintenance dialysis in the province. We will compare those who took statins (medications to lower lipids levels in the blood) to those who did not. By examining these records, we aim to identify patterns and outcomes that will help us understand the impact of statin use on cardiovascular health in patients on dialysis. We will examine key factors, including age, sex, comorbidities (such as diabetes, hypertension, and heart disease), and the intensity and duration of statin use on the outcomes of interest. We will also consider the use of other lipid-lowering agents and medications that might influence cardiovascular health.

Anticipated outcomes: We expect that patients who took statins will have fewer major cardiovascular events compared to those who did not take the medication. Specifically, we anticipate that statin users will experience lower rates of cardiovascular mortality, non-fatal heart attacks and non-fatal strokes,. Additionally, we expect to see a reduction in overall mortality rates and fewer all-cause hospitalizations among statin users. Our study will also explore whether the benefits of statins differ based on different factors such as age, sex, and the presence of other health conditions.

Patient Engagement: While we do not have a patient engagement plan for this study, we believe that our research design and methodology are sufficiently robust to ensure that our findings will be highly relevant and beneficial to patients and healthcare providers alike. We acknowledge the value of patient engagement in research; however, the retrospective nature of this study, which relies on historical medical records, limits the opportunity for direct patient involvement. Instead, our focus is on using comprehensive administrative data to generate information that can directly impact clinical practice.

Relevance to Patients / Community: Our research has the potential to lead to improved guidelines for using statins in dialysis patients, which could significantly lower their risk of heart problems and enhance their quality of life. If we find that statins are beneficial for this population, more dialysis patients could be prescribed these medications, leading to better health outcomes and reduced healthcare costs. This could also influence policy decisions and funding allocations for dialysis care, emphasizing the importance of managing cardiovascular risk in this high-risk group.

Conclusion: Our work will inform clinical practice and decision-making by providing valuable insights into the effectiveness of statin therapy in reducing the risk of cardiovascular events (heart attacks and strokes) and improving survival rates in patients on dialysis. The project has the potential to positively impact the lives of patients by informing treatment strategies that can enhance their cardiovascular health and well-being. Through patient engagement and rigorous analysis, we aim to produce findings that are both scientifically robust and deeply relevant to the needs of our patients.