TY - JOUR
T1 - Effect of statins on total cholesterol concentrations, cardiovascular morbidity, and all-cause mortality in chronic obstructive pulmonary disease
T2 - a population-based cohort study
AU - Sheng, Xia
AU - Murphy, Michael J.
AU - MacDonald, Thomas M.
AU - Schembri, Stuart
AU - Simpson, William
AU - Winter, Janet
AU - Winter, John H.
AU - Wei, Li
N1 - MEDLINE® is the source for the MeSH terms of this document.
PY - 2012
Y1 - 2012
N2 - Background: The benefit of statin use on total cholesterol (IC) concentration has not been studied previously in patients with chronic obstructive pulmonary disease (COPD).Objective: Our study aimed to evaluate statin-associated TC-concentration reduction and subsequent risk for cardiovascular (CV) morbidity and mortality in COPD.Methods: We performed a population-based cohort study using a record-linkage database in Tayside, Scotland. A total of 1017 COPD patients who had at least 2 separate TC measurements between 1993 and 2007 were studied. They were categorized into statin-exposed and statin-unexposed groups according to their statin use status during follow-up. Main outcomes were TC-concentration change from baseline, CV events, and all-cause mortality during follow-up. Multivariate Cox regression models with a time-dependent variable for statins were used to assess risk for outcomes.Results: Statin-associated TC concentrations decreased by 0.86 mmol/L (16%) in patients treated for primary prevention (PP) (n = 1274) and 0.52 mmol/L (11%) in patients treated for secondary prevention (SP) (n = 443), from 5.30 mmol/L and 4.68 mmol/L at baseline, respectively. TC concentrations also declined by 2% in patients free from established CV disease and by 5% in patients with established CV disease in the statin-unexposed groups. A risk reduction of recurrent CV events with statins was observed (adjusted hazard ratio [HR] = 0.35; 95% CI, 0.15-0.87), but not for PP (adjusted HR = 0.84; 95% CI, 0.37-1.89). Statins reduced CV mortality (adjusted HR = 0.32; 95% CI, 0.13-0.77) in SP but not PP. There were statistically significant reductions in all-cause mortality in both PP (adjusted HR = 0.61; 95% CI, 0.43-0.85) and SP (adjusted HR = 0.58; 95% CI, 0.35-0.97).Conclusions: In patients with COPD, statins were protective from CV events and CV mortality in SP but not PP, and statins improved all-cause mortality in both PP and SP. (Clin Ther. 2012;34:374-384) (C) 2012 Elsevier HS Journals, Inc. All rights reserved.
AB - Background: The benefit of statin use on total cholesterol (IC) concentration has not been studied previously in patients with chronic obstructive pulmonary disease (COPD).Objective: Our study aimed to evaluate statin-associated TC-concentration reduction and subsequent risk for cardiovascular (CV) morbidity and mortality in COPD.Methods: We performed a population-based cohort study using a record-linkage database in Tayside, Scotland. A total of 1017 COPD patients who had at least 2 separate TC measurements between 1993 and 2007 were studied. They were categorized into statin-exposed and statin-unexposed groups according to their statin use status during follow-up. Main outcomes were TC-concentration change from baseline, CV events, and all-cause mortality during follow-up. Multivariate Cox regression models with a time-dependent variable for statins were used to assess risk for outcomes.Results: Statin-associated TC concentrations decreased by 0.86 mmol/L (16%) in patients treated for primary prevention (PP) (n = 1274) and 0.52 mmol/L (11%) in patients treated for secondary prevention (SP) (n = 443), from 5.30 mmol/L and 4.68 mmol/L at baseline, respectively. TC concentrations also declined by 2% in patients free from established CV disease and by 5% in patients with established CV disease in the statin-unexposed groups. A risk reduction of recurrent CV events with statins was observed (adjusted hazard ratio [HR] = 0.35; 95% CI, 0.15-0.87), but not for PP (adjusted HR = 0.84; 95% CI, 0.37-1.89). Statins reduced CV mortality (adjusted HR = 0.32; 95% CI, 0.13-0.77) in SP but not PP. There were statistically significant reductions in all-cause mortality in both PP (adjusted HR = 0.61; 95% CI, 0.43-0.85) and SP (adjusted HR = 0.58; 95% CI, 0.35-0.97).Conclusions: In patients with COPD, statins were protective from CV events and CV mortality in SP but not PP, and statins improved all-cause mortality in both PP and SP. (Clin Ther. 2012;34:374-384) (C) 2012 Elsevier HS Journals, Inc. All rights reserved.
UR - http://www.scopus.com/inward/record.url?scp=84856740300&partnerID=8YFLogxK
U2 - 10.1016/j.clinthera.2011.12.014
DO - 10.1016/j.clinthera.2011.12.014
M3 - Article
C2 - 22244052
SN - 1532-6535
VL - 34
SP - 374
EP - 384
JO - Clinical Pharmacology & Therapeutics
JF - Clinical Pharmacology & Therapeutics
IS - 2
ER -