Primary Prevention of Cardiocerebrovascular Diseases and Related Deaths According to Statin Type.

Joungyoun Kim,Woojung Yang,Hee-Taik Kang,Hyeong-Seop Kim,Jae-Woo Lee

doi:10.3390/ijerph17176309

Abstract

(1) Background: Statin is the mainstay of treatment for the primary prevention of atherosclerotic cardiocerebrovascular diseases (CCVDs) in adults with hypercholesterolemia. This study aims to investigate the differences in effect on primary composite outcomes (CCVDs and CCVD-related deaths) among five statins in hypercholesterolemic individuals. (2) Methods: This retrospective study is based on the Korean National Health Insurance Service-National Health Screening Cohort. Participants, aged 40 to 69 years at baseline, were categorized into five statin-treated groups (pitavastatin, atorvastatin, rosuvastatin, simvastatin, and pravastatin) and two untreated groups (untreated hypercholesterolemia and no hypercholesterolemia). (3) Results: A total of 161,583 individuals was included. The median follow-up period was 8.2 years. Compared with the pitavastatin group, the hazard ratios (HRs; 95% confidence intervals (CIs)) for CCVDs and CCVD-related deaths of the atorvastatin, rosuvastatin, simvastatin, pravastatin, untreated hypercholesterolemia, and no-hypercholesterolemia groups were 0.969 (0.567–1.657), 0.988 (0.533–1.832), 0.862 (0.490–1.518), 0.906 (0.326–2.515), 2.665 (1.556–4.562), and 0.656 (0.388–1.110), respectively, in men and 1.124 (0.632–1.999), 1.119 (0.582–2.152), 1.324 (0.730–2.400), 1.023 (0.330–3.171), 2.650 (1.476–4.758), and 0.921 (0.522–1.625), respectively, in women, after being fully adjusted. (4) Conclusions: No significant differences among the five statins were observed, but there was an increased risk in untreated hypercholesterolemic individuals, for CCVDs and CCVDs-related deaths in individuals with hypercholesterolemia of either sex.

Highlights

Cardiovascular and cerebrovascular diseases are the second and fourth most common causes of death in Korea, respectively [1]
The aim of this study is to investigate which among the five most commonly used statins is more effective in preventing atherosclerotic cardiocerebrovascular diseases (CCVDs) and related deaths in individuals without a past history of CCVDs, after setting untreated hypercholesterolemia and no-hypercholesterolemia as control groups
We found no significant difference in the prevention of CCVDs and CCVD-related deaths among the seven groups, including five statins, in either sex

Summary

Introduction

Cardiovascular and cerebrovascular diseases are the second and fourth most common causes of death in Korea, respectively [1]. The prevention of cardiocerebrovascular diseases (CCVDs) will help substantially reduce mortality and its associated public health burden. Most studies have indicated that statins reduce the risk of the first event in otherwise healthy individuals at high risk of atherosclerotic CCVDs [2,3,4]. Most clinical practice guidelines recommend statin treatment for the primary prevention of atherosclerotic CCVDs in adults with hypercholesterolemia [5,6]. Res. Public Health 2020, 17, 6309; doi:10.3390/ijerph17176309 www.mdpi.com/journal/ijerph

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