摘要Objective Patients with chronic kidney disease(CKD)without atherosclerotic cardiovascular disease(ASCVD)have high mortality rates.Guidelines indicate that statin therapy can reduce mortality in CKD patients with ASCVD;however,its benefits for CKD patients without ASCVD remain unclear.This study examined the survival benefits of statin therapy in CKD patients without ASCVD in American and Chinese cohorts.Methods A total of 4369 patients diagnosed with CKD without concurrent ASCVD were included from the American Medi-cal Information Mart for Intensive Care(MIMIC)-Ⅳ database(n=1786)and the Chinese Multicenter Registry Cohort for Cardiorenal Improvement Ⅱ(CIN-Ⅱ,n=2583).Participants were grouped by statin use(treated and untreated).The two groups were compared for key indicators,including:(1)statin use rate;(2)4-year all-cause mortality;(3)4-year cardiovascu-lar mortality(assessed in the CIN-Ⅱ cohort).Statistical analyses included Kaplan-Meier survival curves(with log-rank test for group differences)and Cox proportional hazard models(adjusted for confounders)to estimate the association between statin use and mortality.Results In the MIMIC-Ⅳ cohort,37.6％of CKD patients received statins,with a 4-year all-cause mortality of 36.3％.After adjustment,statin therapy was associated with lower all-cause mortality(adjusted hazard ratio[aHR]:0.61;95％confi-dence interval[CI]:0.51-0.72;P＜0.001).In the CIN-Ⅱ cohort,33.9％of patients received statins;the 4-year all-cause and cardiovascular mortalities were 10.5％and 5.3％,respectively.Adjusted analyses demonstrated that statin therapy reduced both all-cause mortality(aHR:0.74;95％CI:0.56-0.99;P=0.037)and cardiovascular mortality(aHR:0.64;95％CI:0.42-0.97;P=0.031).Conclusion Approximately two-thirds of CKD patients without ASCVD in both the American(MIMIC-Ⅳ)and Chinese(CIN-Ⅱ)cohorts did not receive statins.However,statin therapy reduced 4-year all-cause mortality by 26％and 39％in the American and Chinese cohorts,respectively.These findings highlight a clear survival benefit of statin therapy and warrant future randomized controlled trials.