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Association Between Statin Use, Intensity and Acute Liver Injury in Human Immunodeficiency Virus, Hepatitis C Virus, and Uninfected US Veterans.
- Source :
-
American journal of cardiovascular drugs : drugs, devices, and other interventions [Am J Cardiovasc Drugs] 2021 Jan; Vol. 21 (1), pp. 103-112. - Publication Year :
- 2021
-
Abstract
- Objective: We sought to evaluate the relationship between acute liver injury (ALI) and statins utilizing the Veterans Affairs Informatics and Computing Infrastructure (VINCI) database.<br />Methods: This retrospective cohort study, spanning January 2000-December 2018, compared ALI (aminotransferase > 200 U/L, severe ALI, and hospitalization with ALI) in statin users and non-users among uninfected, hepatitis C virus (HCV) mono-infected, human immunodeficiency virus (HIV)/HCV co-infected, and HIV mono-infected veterans within 18 months. We estimated adjusted Cox proportional hazards models comparing statin users and non-users and comparing statin intensity level with non-use; and estimate Cox proportional hazards models utilizing time-dependent coding of statin intensity. Adjusted models included restricted cubic splines of the propensity score as an adjustment variable.<br />Results: From a total of 166,439 patients who met the study criteria, statin initiators were older, had higher values of body mass index, higher values of low-density lipoprotein cholesterol and triglycerides, and lower values of high-density lipoprotein cholesterol. HCV mono-infected and HIV/HCV co-infected cohorts had the highest rates of ALI, and statin users had lower rates across all outcomes of ALI compared with non-users in unadjusted analysis. Statin use is associated with a lower risk of all ALI outcomes compared with non-users. Patients on a high intensity are not associated with a statistically significant increase in risk for any ALI outcome. For each additional 30 days of treatment, there was a reduced risk of any ALI outcome across all cohorts.<br />Conclusions: Statin initiators had a lower risk of any ALI outcome compared with non-users within 18 months regardless of HIV and/or HCV status.
- Subjects :
- Adult
Age Factors
Aged
Body Mass Index
Comorbidity
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage
Kaplan-Meier Estimate
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Risk Factors
Sex Factors
Socioeconomic Factors
Transaminases blood
HIV Infections epidemiology
Hepatitis C epidemiology
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Liver Failure, Acute epidemiology
Veterans
Subjects
Details
- Language :
- English
- ISSN :
- 1179-187X
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of cardiovascular drugs : drugs, devices, and other interventions
- Publication Type :
- Academic Journal
- Accession number :
- 32239436
- Full Text :
- https://doi.org/10.1007/s40256-020-00404-2