By Dr Deepu
Recently published study in atherosclerosis journal has found
that the risk for CAD was lower in all statin-treated patients with ACOS. Whereas
the risk for ischemic stroke was lower only in long-term statin users with ACOS.
There was no link between risk for
hemorrhagic stroke and statin use.
A retrospective cohort study was conducted using data from
the Longitudinal Health Insurance Database, which included 1 million enrollees
in the Taiwan National Health Insurance program from January 1, 2000, through
December 31, 2011.
Patients ≥20 years of age with ACOS who were treated with
statins (n=916) and those who did not receive statin therapy (n=6338) were
enrolled in the study. Investigators examined the cumulative incidence of CAD
and stroke (both ischemic and hemorrhagic) with the use of time-dependent Cox
proportional regression. Following adjustments for age, sex, inhaled corticosteroid
use, oral steroid use, and comorbidities, adjusted hazard ratios (aHRs) and 95%
CIs for CAD or stroke in statin users (long-term statin use: >600 days;
short-term statin use: ≤600 days) were compared with these values in statin
nonusers.
In statin users, the aHRs for CAD and stroke were 0.50 (95%
CI, 0.41-0.62) and 0.83 (95% CI, 0.63-1.09), respectively. Furthermore, aHRs
for ischemic and hemorrhagic stroke were 0.30 (95% CI, 0.09-0.99) and 0.90 (95%
CI, 0.68-1.20), respectively. In addition, in long-term statin users, aHRs for
CAD and stroke were 0.23 (95% CI, 0.13-0.41) and 0.42 (95% CI, 0.19-0.89),
respectively. In short-term statin users, aHRs for CAD and stroke were 0.58
(95% CI, 0.47-0.71) and 0.93 (95% CI, 0.70-1.23), respectively.
A major limitation of the current study is that lipid levels
were not taken into account. Moreover, although a new-user study design was
employed, with propensity score matching and a time-dependent model for
analysis, results were not as accurate as those derived from randomized
controlled trials.
The investigators concluded that regardless of the duration
of statin use, the risk for CAD was lower in all
statin-treated patients with ACOS. In contrast, the risk for ischemic stroke
was lower only in long-term statin users with ACOS, and no link was observed
between risk for hemorrhagic stroke and use of statin therapy.
The study was published in atherosclerosis journal
