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Statins are associated with a large reduction in all-cause mortality in women from a cardiac outpatient population
- Source :
- Bots, S H, Onland-Moret, N C, Jancev, M, Hollander, M, Tulevski, I I, Hofstra, L, Somsen, G A & den Ruijter, H M 2022, ' Statins are associated with a large reduction in all-cause mortality in women from a cardiac outpatient population ', Open Heart, vol. 9, no. 1, e001900 . https://doi.org/10.1136/openhrt-2021-001900, Open Heart, 9(1), 1. BMJ Publishing Group, Open Heart, 9(1):e001900. BMJ Publishing Group
- Publication Year :
- 2022
-
Abstract
- ObjectivesUncertainty about the benefit of (high-intensity) statins for women remains due to under-representation of women in primary prevention trials and scarcity of sex-stratified data. This study evaluates the sex-specific relation between statin treatment and survival and the additional benefit of high-intensity statins.MethodsElectronic health record data from 47 801 patients (17 008 statin users and 30 793 non-users) without prior cardiovascular disease were extracted from thirteen Dutch outpatient cardiology clinics. Patients prescribed statins at baseline were propensity-score matched to those eligible for statin therapy (low-density lipoprotein >2.5 mmol/L) without a statin prescription. Statins were divided into low-intensity and high-intensity according to Dutch guidelines. Mortality data were obtained via linkage to the national mortality registry. Cox regression was used to evaluate the relationship between statin prescription and intensity and all-cause and cardiovascular mortality.ResultsPropensity score matching created a cohort of 8631 statin users and 8631 non-users. 35% of women and 28% of men received a low-intensity statin. The beneficial effect of statins on both all-cause and cardiovascular mortality was stronger in women (HR 0.66, 95% CI 0.58 to 0.74 and HR 0.55, 95% CI 0.39 to 0.71, respectively) than in men (HR 0.89, 95% CI 0.81 to 0.95 and HR 0.93, 95% CI 0.77 to 1.08, respectively). High-intensity statins conferred modest protection against all-cause mortality (HR 0.94, 95% CI 0.88 to 1.00) and cardiovascular mortality (HR 0.86, 95% CI 0.74 to 0.98) in both sexes.ConclusionsThe protective effect of primary prevention statins was stronger in women than men for both all-cause and cardiovascular mortality. High-intensity statins conferred a modest additional benefit in both sexes. Statins seem to be effective regardless of treatment intensity, especially in women.
- Subjects :
- Male
Risk
Primary prevention
Efficacy
nutritional and metabolic diseases
Individual data
Metaanalysis
Cohort Studies
Ldl cholesterol
Cardiovascular Diseases
Outpatients
Humans
Female
Disease
lipids (amino acids, peptides, and proteins)
Therapy
cardiovascular diseases
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Safety
Propensity Score
Cardiology and Cardiovascular Medicine
Subjects
Details
- Language :
- English
- ISSN :
- 20533624 and 2398595X
- Database :
- OpenAIRE
- Journal :
- Bots, S H, Onland-Moret, N C, Jancev, M, Hollander, M, Tulevski, I I, Hofstra, L, Somsen, G A & den Ruijter, H M 2022, ' Statins are associated with a large reduction in all-cause mortality in women from a cardiac outpatient population ', Open Heart, vol. 9, no. 1, e001900 . https://doi.org/10.1136/openhrt-2021-001900, Open Heart, 9(1), 1. BMJ Publishing Group, Open Heart, 9(1):e001900. BMJ Publishing Group
- Accession number :
- edsair.doi.dedup.....bcb65585c5e3b6f3f0920df7af988999