Association between LDL-C and Risk of Myocardial Infarction in CKD. J Am Soc Nephrol 2013; 24: 979 986 with permission from American Society of Nephrology22 conveyed through Copyright Clearance Center, Inc; accessed http://jasn.asnjournals.org/ Rates per person years No CKD No CKD No DM No DM No DM Prior MI Prior MI No CKD No DM No DM Prior MI No prior MI No prior MI No prior MI DM No CKD No prior MI No prior MI DM DM CKD CKD CKD CKD CKD+1 or more of DM, MI, PTCA/CABG, CVA/TIA Age 50 Age > 50 MI CHD death or MI Figure 2 | Future 10-year coronary risk based on various patient characteristics. Data are unadjusted rates from 1,268,029 participants in the Alberta Kidney Disease cohort. CKD refers to eGFR 15-59.9 ml/min/1.73 m2 or with proteinuria. CABG, coronary artery bypass grafting; CHD, coronary heart disease; CKD, chronic kidney disease; CVA, cerebrovascular accident; DM, diabetes mellitus; MI, myocardial infarction; PTCA, percutaneous transluminal coronary angioplasty; TIA, transient ischemic attack. the benchmark for assessing future coronary risk; the risk in patients with prior MI (in whom the rate of new MI is 20 per 1000 patient-years) is generally considered as sufficiently high to clearly warrant ongoing statin treatment.12 Most national guidelines for the general population also recommend universal or very liberal use of statin treatment among those with coronary risk that is lower than those with prior MI (but still substantially higher than average), such as those with diabetes or prior stroke.12,24 26 There is no consensus on the level of future coronary risk that is sufficient to justify statin treatment, but in the judgment of the Work Group rates of coronary death or non-fatal MI o10 per 1000 patient-years are unlikely to be broadly accepted as an indication for treatment. 