Previous Statin Use Research Articles

Incidence of statin-associated muscle symptoms in patients taking statins with RYR1 or CACNA1S variants.

Background: Statins are commonly used medications. Variants in SLCO1B1, CYP2C9, and ABCG2 are known predictors of muscle effects when taking statins. More exploratory genes include RYR1 and CACNA1S, which can also be associated with disease conditions. Methods: Patients with pathogenic/likely pathogenic variants in RYR1 or CACNA1S were identified through an elective genomic testing program. Through chart review, patients with a history of statin use were assessed for statin-associated muscle symptoms (SAMS) along with collection of demographics and other known risk factors for SAMS. Results: Of the 23 patients who had a pathogenic or likely pathogenic RYR1 or CACNA1S variant found, 12 had previous statin use; of these, SAMS were identified in four patients. Conclusion: These data contribute to previous literature suggesting patients with RYR1 variants may have an increased SAMS risk. Additional research will be helpful in further investigating this relationship and providing recommendations.

Correlation between lipid-lowering therapy and cerebral microbleeds.

To investigate if there is a correlation between lipid-lowering treatment with statins and the occurrence, number, and location of cerebral microbleeds (CMBs) among patients with ischemic cerebrovascular disease (ICVD), and also to compare treatment with atorvastatin and rosuvastatin in terms of the occurrence of CMBs and their differences. In this retrospective study, we included patients who were diagnosed with ICVD and underwent susceptibility weighted imaging (SWI) in a grade A tertiary hospital from October 1, 2014 to October 1, 2022. We collected information on previous statin use, past medical history, clinical test indicators, and imaging data. We found that out of 522 patients, 310 patients (59.4%) had no CMB and 212 patients (40.6%) had CMBs. There was no statistically significant correlation between prior statin use, the occurrence, and number of CMBs in patients diagnosed with ICVD (P < 0.05). As for the location of CMB, there was a statistically significant correlation between prior statin use and lobar CMBs (P < 0.048). However, there was no statistically significant correlation between the use of atorvastatin and rosuvastatin and the occurrence of CMBs (P > 0.05). There was no independent correlation between previous statin use, and the occurrence, and number of CMBs in patients with ICVD. As for CMBs in different locations, there was a correlation between previous use of statin and lobar CMBs. There was no significant difference between atorvastatin and rosuvastatin in the occurrence of CMBs in patients with ICVD.

Impact of previous statin use on first intracerebral hemorrhage in cerebral amyloid angiopathy

ObjectivesStatins have been associated with an increased risk of spontaneous intracerebral hemorrhage (ICH), but without dedicated study in cerebral amyloid angiopathy (CAA). We aimed to evaluate the association between previous statin treatment and radiological hemorrhagic lesions in a CAA population during a first lobar ICH event. Materials and methodsWe retrospectively included all patients meeting the modified Boston criteria for probable CAA and admitted for a first lobar ICH between 2010 and 2021 at Rouen University Hospital. Patients were classified as having previous statin treatment or not. We compared the ICH volume, the number of associated cerebral microbleeds (CMBs), and cortical superficial siderosis (CSS) according to previous statin treatment or not. We also compared functional outcomes and ICH recurrence during the follow-up period between the two groups. ResultsWe included 99 patients, 27 of whom had statin treatment prior to their ICH. The ICH volume and the number of CMBs did not differ between groups. Disseminated CSS was initially more frequent in the statin group (88% versus 57%; P=0.019), but this was no longer significant after adjustment for antiplatelet treatment (P=0.13). The long-term outcome was similar between the two groups with no increased risk of ICH recurrence in the statin-treated group (29.63% versus 23.61%, P=0.54). ConclusionsPrevious statin treatment was not associated with more severe hemorrhagic lesions in CAA in terms of ICH volume or number of microbleeds, but a trend for increased disseminated CSS was highlighted, which will require further larger studies.

Statin use improves the outcomes in patients with atrial fibrillation: A population-based study

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Sanmin project, Shenzhen, China Background There is inconclusive evidence regarding the impact of statins on the risk of atrial fibrillation (AF) related outcomes. The current study investigated whether statin use would improve outcomes among patients with non-valvular AF. Purpose To assess the association between statin use and AF-related outcomes among patients with AF. Methods Patients newly diagnosed with AF (n = 51,472) between 2010-2018 were divided into statin users (n =11,866) and statin nonusers (n =39,606), according to whether they received statin therapy after their first diagnosis of AF. The primary outcomes included ischaemic stroke (IS) and systemic embolism (SE), haemorrhagic stroke (HS), and transient ischaemic attack (TIA). An inverse probability of treatment weighting was used to balance baseline covariates between the two groups. The Fine and Grey competing risks model was applied, with death defined as the competing event. Results The median age of the cohort was 74.9 years, and 47.7% were female. During the median follow-up of 5.1 years, previous statin use was significantly associated with a lower risk of IS/SE compared with statin nonusers (subdistribution hazard ratio [SHR] = 0.83, 95%CI: 0.78-0.89). Similar patterns were found in the association between previous statin use and HS (SHR = 0.93, 95%CI: 0.89-0.98) and TIA (SHR = 0.85, 95%CI: 0.80-0.90, P &amp;lt;0.01). Moreover, ≥6 years of statin use predicted a lower risk of IS/SE, HS and TIA (IS/SE: SHR = 0.57, 95%CI: 0.54-0.61; HS: SHR = 0.56, 95%CI: 0.53-0.60; TIA: SHR = 0.58, 95%CI: 0.52-0.64) compared to those with short-term (3 months to &amp;lt;2 years) statin use. Stratified analyses demonstrated that the lower risk of IS associated with statin use was consistent. Conclusion Statin use was associated with a lower risk of incident IS/SE, HS and TIA in a duration-dependent manner among AF patients.

J-shaped association between LDL cholesterol and cardiovascular events: A longitudinal primary prevention cohort of over 2.4 million people nationwide

IntroductionLow-density lipoprotein (LDL) cholesterol-lowering treatment is beneficial for the secondary or primary prevention of high-risk atherosclerotic cardiovascular disease (ASCVD). However, the prognostic implications of low LDL cholesterol levels in patients without previous ASCVD and without statin use remain elusive. MethodsFrom a nationwide cohort, 2,432,471 participants without previous ASCVD or statin use were included. For myocardial infarction (MI) and ischemic stroke (IS), participants were followed-up from 2009 to 2018. They were stratified according to 10-year ASCVD risk (<5 %, 5 %–<7.5 %, 7.5 %–<20 %, and ≥20 %) and LDL cholesterol level (<70, 70–99, 100–129, 130–159, 160–189, and ≥190 mg/dL). ResultsThe relationship between LDL cholesterol levels and ASCVD events exhibited a J-shaped curve for both MI and IS. After classification according to the ASCVD risk, this J-shaped relationship was consistently observed for the composite of MI and IS. Participants with an LDL cholesterol level <70 mg/dL showed a higher MI risk than those with a level of 70–99 mg/dL or 100–129 mg/dL in the low-ASCVD risk group. The J-shaped curve between LDL cholesterol levels and MI risk was attenuated across ASCVD risk groups. For IS, participants with an LDL cholesterol level <70 mg/dL demonstrated increased risks compared with those with a level of 70–99 mg/dL, 100–129 mg/dL, or 130–159 mg/dL in the borderline, intermediate, and high ASCVD risk groups, respectively. In contrast, a linear association was observed in participants taking statins. Interestingly, a J-shaped association was observed between LDL cholesterol and high-sensitivity C-reactive protein (hs-CRP) levels; the mean hs-CRP level and the proportion of individuals with increased hs-CRP levels were relatively high among individuals with an LDL cholesterol level <70 mg/dL. ConclusionsAlthough high LDL cholesterol levels increase the risk of ASCVD, low LDL cholesterol levels do not warrant safety from ASCVD. Therefore, individuals with low LDL cholesterol levels should be carefully monitored.

Association between Gallstone Disease and Statin Use: A Nested Case-Control Study in Korea.

The correlation between statin use and the development of gallstone disease remains controversial. Existing data, primarily based on Caucasian populations, are biased, thus necessitating validation studies involving Asian cohorts. We conducted a nested case-control study using data from the Korean National Health Insurance Service Health Screening Cohort (2002-2019) to determine the likelihood of gallstone disease according to periods of previous statin use and type of statin. Among the 514,866 participants, 22,636 diagnosed with gallstones at ≥2 clinic visits (using the International Classification of Diseases, 10th revision, code K80) were matched 1:4 to 90,544 controls for age, sex, income, and residential area, and their statin prescription history for 2 years prior to the index date was examined. Propensity-score-weighted odds ratios (ORs) for gallstone disease were calculated using conditional logistic regression. Long-term use (>545 days) of any statin or lipophilic statins was associated with lower odds of incident gallstones (OR = 0.91, 95% confidence interval [CI] = 0.86-0.96, p < 0.001 and OR = 0.88, 95% CI = 0.83-0.93, p < 0.001, respectively) after adjusting for confounders. Short-term use (180-545 days) of any statin or hydrophilic statins was not statistically related to incident gallstones. In summary, prior statin medication, particularly long-term lipophilic statin use, may confer a preventive advantage against gallstone disease.

Factors associated with two different stroke mechanisms in perforator infarctions regarding the shape of arteries

Two different stroke mechanisms are involved in small vessel disease: branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD). We compared mechanisms of stroke in lenticulostriate arteries (LSA) vs. anterior pontine arteries (APA) and verified factors associated with stroke mechanisms, including shape of middle cerebral artery (MCA) and basilar artery (BA). We retrospectively reviewed patients with acute ischemic stroke with penetrating artery territory confirmed by MRI. The mechanisms of stroke were categorized based on diffusion-weighted imaging; BAD was defined as lesion larger than 10 mm in LSA and lesions involving basal pontine in APA. Other lesions were classified as LD. The shapes of MCA and BA were classified as straight, with one angle, or with two angles (U, C or S shape, respectively) using anterior–posterior view. The study included 221 patients. LD was more common in LSA infarcts, but BAD was more common in APA infarcts (p < 0.001). Low initial National Institutes of Health Stroke Scale [Adjusted Odds ratio (aOR) = 0.78; p < 0.001], absence of hyperlipidemia [aOR = 0.31; p = 0.002], previous statin use [aOR = 4.35; p = 0.028] LSA infarcts [reference = APA territory; aOR = 11.07; p < 0.001], and S-shaped vessels (reference = straight shaped vessels; aOR = 3.51; p = 0.004) were independently associated with LD. Angulations in the mother vessels may be more associated with true small vessel disease more with LD than BAD.

Correlation of the characteristics of symptomatic intracranial atherosclerotic plaques with stroke types and risk of stroke recurrence: a cohort study.

BackgroundSymptomatic intracranial atherosclerotic stenosis (sICAS) patients had a higher risk of stroke recurrence, and the risk of acute ischemic stroke (AIS) was higher than transient ischemic attack (TIA). Therefore, it is important to explore the risk factors associated with sICAS clinical subtypes and the risk of stroke recurrence. The purpose of this study was to investigate the association between intracranial arterial culprit plaque characteristics with sICAS clinical subtypes and the risk of stroke recurrence.MethodsA total of 206 patients with sICAS were included. Baseline demographic data and relevant serologic indices were collected from all participants. All participants were assessed by high-resolution vessel wall imaging (HR-VWI) for culprit vessel and culprit plaque characteristics. The follow-up method was outpatient or telephone follow-up. Associated factors for sICAS clinical subtypes were analyzed by binary logistic regression. Cox proportional hazard regression analysis were used to analysis the independent risk factors for recurrent stroke.ResultsIn this group, there were 154 patients with AIS, 52 patients with TIA, 124 patients with anterior circulation ischemic symptom (ACiS), and 82 patients with posterior circulation ischemic symptom (PCiS). Male gender [odds ratio (OR) =5.575, 95% confidence interval (CI): 2.120 to 14.658], history of previous statin use (OR =0.309, 95% CI: 0.113 to 0.843) and serum apolipoprotein A/B values (OR =0.363, 95% CI: 0.139 to 0.948) were associated factors for AIS. A total of 24 patients (11.7%) experienced stroke recurrence during the 1-year follow-up period. Hyperintensity on T1 weighted imaging (T1WI) in the culprit plaque [hazard ratio (HR) =3.798, 95% CI: 1.433 to 10.062] was an independent risk factor for stroke recurrence. The incidence of significant enhancement (62.2% vs. 39.5%, χ2=9.681, P=0.002), positive remodeling (69.5% vs. 52.4%, χ2=5.661, P=0.020), and hyperintensity on T1WI (42.7% vs. 22.6%, χ2=16.472, P=0.003) was higher in the posterior circulation than in the anterior circulation.ConclusionsThe characteristics of intracranial arterial culprit plaques were independent risk factors for recurrent stroke, and there were differences in the plaque characteristics of anterior and posterior circulation. Early HR-VWI examination for sICAS patients is of great significance for patient risk stratification and personalized management.

Statin discontinuation in persons with and without Alzheimer’s disease

BackgroundAlthough statin use is reported to decrease after dementia diagnosis, time to statin discontinuation and factors associated with discontinuation have not been studied in persons with Alzheimer’s disease (AD). We compared the risk of discontinuation and factors associated with discontinuation, including secondary and primary prevention indication, in statin users with and without AD.MethodsThe register-based Medication Use and Alzheimer’s Disease (MEDALZ) cohort includes community dwellers with a clinically verified AD diagnosed during 2005–2011 in Finland. On the AD diagnosis date (index date), each person with AD was matched with a comparison person without AD. We included 25,137 people with AD and 22,692 without AD who used statin on the index date or initiated within 90 days after. Cox regression models restricted to 4-year follow-up were conducted.ResultThe median time to statin discontinuation was 1.46 years in people with AD and 1.36 years in people without AD. People with AD were more likely to discontinue than people without AD (adjusted HR (aHR) 1.20 (95% CI 1.18–1.24)). This was observed for both primary (aHR 1.11 (1.06–1.16)) and secondary prevention (aHR 1.30 (1.25–1.35)) purpose. Factors associated with discontinuation included higher age and female gender, whereas concomitant cardiovascular drug use and previous statin use were associated with decreased risk.ConclusionThe absolute difference in discontinuation rates was small, and the same factors were associated with statin discontinuation in people with and without AD. The findings suggest that cognitive decline plays a minor role on statin discontinuation.

Incident Rheumatoid Arthritis Following Statin Use: From the View of a National Cohort Study in Korea.

Safety issues regarding the potential risk of statins and incident rheumatoid arthritis (RA) have been raised, but the existing data are largely based on Caucasian populations, and continue to have biases and require further validation in Asian populations. Here, we aimed to verify the risk of RA depending on the duration of previous statin use and statin types using a large-scale, nationwide database. This study enrolled 3149 patients with RA and 12,596 matched non-RA participants from the national health insurance database (2002–2015), and investigated their statin prescription histories for two years before the index date. Propensity score overlap-weighted logistic regression was applied after adjusting for multiple covariates. The prior use of any statins and, specifically, the long-term use of lipophilic statins (>365 days) were related to a lower likelihood of developing RA ((odds ratio (OR) = 0.73; 95% confidence intervals (CI) = 0.63–0.85, p < 0.001) and (OR = 0.71; 95% CI = 0.61–0.84, p < 0.001), respectively). Subgroup analyses supported these preventive effects on RA in those with dyslipidemia, independent of sex, age, smoking, alcohol use, hypertension, and hyperglycemia. Hydrophilic statin use or short-term use showed no such associations. Our study suggests that prior statin use, especially long-term lipophilic statin use, appears to confer preventive benefits against RA.

The Influence of Prior Statin Use on the Prevalence and Exacerbation of Chronic Obstructive Pulmonary Disease in an Adult Population.

BackgroundStatins have anti-inflammatory and antioxidant properties, and previous studies have reported the positive effects of statins on chronic obstructive pulmonary disease (COPD) outcomes. However, the effects of statins on the development and acute exacerbations of COPD remain unclear. Therefore, this study aimed to assess the relation between statin use and COPD occurrence in all participants and the link between statin use and COPD acute exacerbations in participants with COPD.MethodsThis case-control study comprised 26,875 COPD participants and 107,500 control participants who were 1:4 matched from the Korean National Health Insurance Service-Health Screening Cohort. Conditional logistic regression was used to evaluate the probability of COPD occurrence associated with previous statin use. In addition, unconditional logistic regression was employed to assess the risk of exacerbations related to statin use among COPD participants. These relations were estimated in subgroup analysis according to statin type (lipophilic vs. hydrophilic).ResultsThe association between previous statin use and the occurrence of COPD did not reach statistical significance in the overall population (adjusted odds ratio [aOR] = 0.96, 95% confidence interval [CI] = 0.93–1.00, P = 0.059). However, statin use decreased the probability of exacerbations in participants with COPD (aOR = 0.79, 95% CI = 0.74–0.85, P < 0.001). Lipophilic statins decreased the probability of exacerbations, whereas hydrophilic statins were not associated with a decreased likelihood of exacerbations (aOR = 0.78, 95% CI = 0.72–0.84, P < 0.001 for lipophilic statins; aOR = 0.89, 95% CI = 0.78–1.02, P = 0.102 for hydrophilic statins).DiscussionStatin use was not associated with the occurrence of COPD in the adult population. However, statin use was associated with a reduced probability of exacerbations in participants with COPD, with a greater risk reduction with lipophilic statin use.

Abstract WMP11: Predictors Of Early Neurological Deterioration After Dual Antiplatelet Therapy In Patients With Cerebral Infarction

Background: Recent clinical evidence supports the early initiation of aspirin and clopidogrel combination for patients with minor stroke or high-risk transient ischemic attack (TIA) to prevent stroke recurrence. However, some of the patients still experience early neurological deterioration (END) despite optimal antithrombotic treatment. We investigated clinical and laboratory variables related to END after optimal antithrombotic treatment among the patients with non-cardioembolic stroke or TIA. Methods: The patients with minor neurological deficit who received aspirin and clopidogrel within 24 hours after symptom onset were selected from the prospective stroke registries of Seoul National University and Chung-Ang University Hospital, in Seoul, Korea. The END due to ischemic stroke (END_IS) was defined as two or more national institute health stroke scale increase within 5 days after stroke which us due to stroke progression or recurrence. Included patients were divided into two groups according to the presence of END_IS and demographic and laboratory variables were compared between the two groups. Multivariable logistic regression analysis was performed to assess the independent predictors of the END. Results: During the study period from January 2015 to January 2021, 33 (8.7%) out of 380 patients experienced END_IS. In multivariate analysis, independent predictors of END_IS were the presence of intracranial artery stenosis ≥ 50% (odds ratio [OR] 2.922, [95% CI, 1.342-6.364], p=0.007), higher initial NIHSS score, (OR 1.502 [95% CI 1.120-2.015], p=0.007), previous use of statin (OR 0.282 [95% CI 0.080-0.990], p=0.007) and higher serum D-dimer level (OR 1.408 [95% CI, 1.074-1.847], p=0.048). Conclusions: Intracranial artery stenosis, stroke severity, previous statin use, and D-dimer level were the independent predictors of END_IS after dual-antiplatelet treatment in patients with minor stroke. Future studies are necessary to develop an additional therapeutic strategy for the at-risk patient group.

Thrombotic microangiopathy in primary antiphospholipid syndrome is linked to stroke and less deep venous thrombosis.

To compare clinical and laboratory data obtained from patients with primary Antiphospholipid Syndrome (pAPS) with and without Thrombotic Microangiopathy (TMA). A cross-sectional study with 66 (83.3% female) pAPS patients was performed. Demographic, clinical, drug use, antiphospholipid antibodies data were evaluated. Patients were subdivided into one of two groups: pAPS with TMA and pAPS without TMA and were compared. In this sample, 5/66 (7.6%) of patients had TMA. Primary APS with TMA group exhibited a higher frequency of arterial events (100% vs. 54.1%, p=0.02), stroke (100% vs. 32.8%, p=0.001) and a lower frequency of deep venous thrombosis (0 vs. 68.9%, p=0.0009) compared to the patients without TMA. Analysis of therapy used in these patients showed a higher frequency of current (40% vs. 6.6%, p=0.0006) and previous glucocorticoid use (80% vs. 36%, p=0.0007) and statin use (50% vs. 22.9%, p=0.037) in the first group. The two groups exhibited no differences in the frequency of positive autoantibodies, except for higher IgG anticardiolipin titers (86 ± 52 vs. 34.5 ± 39 GPL, p=0.003). Patients with pAPS and TMA have distinct clinical and laboratory spectra from those without TMA, that is characterized by an increased frequency of arterial events, stroke, and higher titers of IgG anticardiolipin; they have deep venous thrombosis less frequently.

Association between Statin Use and Meniere's Disease: Results from a National Health Screening Cohort.

The protective effects of statins against inner ear diseases have been suggested. This study investigated the relationship between previous statin use and the occurrence of Meniere’s disease (MD). Participants ≥40 years old in the Korean National Health Insurance Service-Health Screening Cohort 2002–2015 were enrolled. A total of 7734 MD participants were matched with 38,670 comparison participants. The dates of statin prescriptions for the 2 years before the onset of MD were examined. A conditional logistic regression analysis was performed to estimate the odds ratios (ORs) of statin use for MD. Regarding the different types of statins, lipophilic statins, but not hydrophilic statins, were associated with lower odds of MD in the <65 year-old group (adjusted OR = 0.81, 95% CI = 0.68–0.97, p = 0.023). Prior statin use did not show association with MD in the adult population. Regarding the different types of statins, lipophilic statin use was related to a lower rate of MD in a middle-aged population.

Association between statin medication and hearing impairment in a national health screening cohort

This study aimed to investigate the association of previous stain use with hearing impairment in an adult population. Data from the ≥ 40-year-old population in the Korean National Health Insurance Service Health Screening Cohort were used. The hearing impairment group was classified based on the national registry of hearing-impaired persons. Control participants were randomly selected and matched for age, sex, income, and region of residence. The number of days of statin prescription during the 2 years before the diagnosis of hearing impairment was compared between the hearing impairment group and the control group using conditional logistic regression analysis. Additional analyses were conducted according to age and sex. The number of days of previous statin use was not different between the hearing impairment group and the control group (adjusted odds ratio [aOR] = 0.94, 95% confidence interval (CI) = 0.86–1.02, P = 0.118). According to age, in the ≥ 70-year-old group, those with hearing impairment had 11% lower rates of previous statin use than those in the control group (aOR = 0.89, 95% CI = 0.80–0.99, P = 0.039). According to sex, in the male group, 12% lower rates of previous statin use were observed among those with hearing impairment than among those in the control group (aOR = 0.88, 95% CI = 0.79–0.99, P = 0.037). Previous statin use might have an effect on reducing the prevalence of hearing impairment in elderly individuals and men.

Evaluation of the relationship between previous statin use and thyroid cancer using Korean National Health Insurance Service-Health Screening Cohort data

The association of thyroid cancer with statin use is controversial. This study aimed to investigate the association of previous statin use with thyroid cancer in the ≥ 40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort. The 5501 patients in the thyroid cancer group were matched with the 22,004 patients in the non-thyroid cancer group for age, sex, income, and region of residence. Previous statin use during the 2 years before the diagnosis of thyroid cancer was examined. The odds ratios (ORs) with 95% confidence intervals (CIs) of previous statin use for thyroid cancer were estimated using conditional logistic regression analyses. Additionally, subgroup analyses were conducted. The thyroid cancer group showed more days of previous statin use than the non-thyroid cancer group (72.3, standard deviation [SD] = 181.2 days vs. 64.3, SD = 174.4 days, P = 0.003). Although the odds of previous statin use for thyroid cancer were high in the crude model (OR = 1.10, 95% CI 1.04–1.17, P = 0.002), they were low in the fully adjusted model (OR = 0.89, 95% CI 0.82–0.95, P = 0.001). According to age and sex subgroups, the younger (< 60 years old) male group showed lower odds for thyroid cancer according to previous statin use (adjusted OR = 0.70, 95% CI 0.55–0.88, P = 0.003), but this finding was not observed in other subgroups of older men or in any groups of women. Thyroid cancer was negatively associated with statin use in the previous 2 years in the adjusted model.

Association between Previous Statin Use and Alzheimer's Disease: A Nested Case-Control Study Using a National Health Screening Cohort.

A number of studies report the incidence of Alzheimer’s disease (AD) in patients taking statins, but the results are inconsistent. (1) Background: The present study investigated the cross-sectional association between previous statin use and the risk of AD development in Korean residents. (2) Methods: We used the Korean National Health Insurance Service-National Sample Cohort; 17,172 AD patients were matched by age, gender, income, and region of residence with 68,688 control participants at a ratio of 1:4. We used a multiple conditional logistic regression model to analyse the association between the number of days of statin use and AD occurrence. Further analyses were performed to identify whether this association is maintained for different ages, genders, socioeconomic status groups, and covariates. (3) Results: The odds ratio, which was adjusted for potential confounders, for the days of statin use per year in the AD group compared to the control group was 0.95 (95% confidence interval = 0.92–0.98; p = 0.003). The number of days of statin use in the AD group was significantly smaller in the subgroups of non-smokers and individuals with normal weight, alcohol consumption less than once a week, total cholesterol level below 200 mg/dL, systolic blood pressure below 140, diastolic blood pressure below 90, and fasting blood glucose below 100 mg/dL. (4) Conclusions: Our results suggest that statin use prevents the occurrence of AD. The effects of statin use in preventing AD may be greater in individuals at relatively low risk.

Association Between Sudden Sensorineural Hearing Loss and History of Statin Use: A Nested Case-Control Study.

The effect of statin on sudden sensorineural hearing loss (SSNHL) remains unclear. Thus, this study aimed to investigate the association between prior statin use and SSNHL. A nested case-control study. Participants aged ≥40 years were enrolled from the 2002-2015 Korean National Health Insurance Service-Health Screening Cohort. A total of 5876 patients with SSNHL were matched with 23,504 control participants for age, sex, income, and region of residence. History of statin use for 2 years before SSNHL onset was investigated between the groups. The odds ratios (ORs) of the length of statin use for SSNHL stratified by age, sex, income, and region of residence were analyzed with conditional logistic regression. Dyslipidemia, total cholesterol, blood pressure, blood glucose, hemoglobin, obesity, smoking, alcohol consumption, and Charlson Comorbidity Index score were adjusted. The adjusted variables were subjected to subgroup analyses. The SSNHL group had a longer duration of statin use than the control group (mean [SD], 81.9 [197.7] days vs 72.7 [188.0] days; P = .001). However, statin use was not associated with SSNHL after adjusting for the confounders (adjusted OR, 1.04; 95% CI, 0.98-1.11; P = .245). There was a positive correlation between statin use and SSNHL in the crude model (crude OR, 1.10; 95% CI, 1.04-1.16; P = .001). However, there was no association between statin use and SSNHL in all subgroup analyses. Previous statin use was not associated with SSNHL.

Abstract 15197: Lipopolysaccharide-Nuclear Factor-kappa B Pathway and Lipoprotein Apheresis Effects in Patients With Familial Hypercholesterolemia and Coronary Artery Disease

Introduction: Inflammation may play an important role in atherosclerosis in familial hypercholesterolemia (FH). Lipopolysaccharide (LPS)-nuclear factor-kappa B (NF-κB) pathway is a routine signal process activated in inflammatory status. Hypothesis: We assessed the hypothesis that LPS-NF-κB axis is markedly activated and lipoprotein apheresis has an inhibitory effect on this pathway in patients with FH and coronary artery disease (CAD). Methods: In this matched case-control study a genetically diagnosed FH cohort who presented stable CAD (n=63) was compared with 63 non-FH CAD and 63 non-FH non-CAD controls matched by sex and age. Plasma LPS levels and NF-κB activity were compared among the three groups. In addition, we studied in vitro LPS-induced interleukin-6 production by mononuclear cells from 16 FH cases without previous statin use and compared them with their respective matched control groups. Subsequently, these 16 FH patients underwent lipoprotein apheresis. Blood samples were taken immediately before and regularly after apheresis for measuring LPS and NF-κB. Results: FH plus CAD had higher LPS levels and NF-κB activity than CAD and non-CAD controls (all p &lt;0.01). LPS-induced interleukin-6 production by mononuclear cells of FH plus CAD was also much higher compared with CAD and non-CAD controls (both p &lt;0.01). Moreover, plasma LPS levels ( p &lt;0.001) and NF-κB activity ( p &lt;0.01) were dramatically reduced after apheresis in FH patients. Conclusions: In conclusion, genetically confirmed FH patients with CAD had a marked activation of LPS-NF-κB axis, while lipoprotein apheresis significantly attenuated this key inflammatory pathway, suggesting that inflammation may be an important therapeutic target for FH patients.

Relationship between Bell's Palsy and Previous Statin Use: A Case/Non-Case Study.

We intended to determine the relationship between previous statin use and Bell’s palsy in a large study population receiving statins for the past 2 years. The Korean National Health Insurance Service—Health Screening Cohort data from 2002 to 2015 were collected. Participants with Bell’s palsy (n = 3203) were matched with participants without Bell’s palsy (n = 12,812). The number of days of previous statin use for 2 years before the onset of Bell’s palsy was analyzed using conditional logistic regression. Subgroups of age, sex, obesity, smoking, alcohol consumption, total cholesterol, and blood pressure were analyzed for any association between Bell’s palsy and prior statin use. The Bell’s palsy group reported greater statin use than the non-Bell’s palsy group (84.6 (standard deviation, SD = 201.7) vs. 74.4(SD = 189.4), p = 0.009). Previous statin use was associated with Bell’s palsy in the crude model (95% confidence intervals = 1.03–1.19, p = 0.006). However, this relationship disappeared when the possible covariates were adjusted for in model 2. All subgroups showed no increased odds for Bell’s palsy in previous statin users. We did not find an association between Bell’s palsy and previous statin use in this Korean population aged ≥40 years.