Regular Statin Use Research Articles

Prior Statin Use Is Not Associated With Improved Outcome in Emergency Patients Admitted With Infection: A Prospective Observational Study

The objective was to determine whether prior statin use is associated with lower mortality in emergency patients admitted with infection. A prospective observational study was conducted at the emergency department (ED) of a tertiary adult hospital with an annual census of over 73,000 patients. Patients presenting to the ED who were subsequently hospitalized with a primary diagnosis of infection were identified within 24 hours of presentation. Data were abstracted from patients' charts and from hospital electronic databases. Patients were stratified according to reported regular statin use on presentation. The outcome measure was in-hospital mortality truncated at 30 days. An association between statin use and mortality was sought using logistic regression analysis. Data were collected over a 60-week period from 2,642 admissions. Patients taking a statin on admission had a higher unadjusted mortality risk (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.32 to 3.46) compared to those not on a statin. However, this result became nonsignificant (OR = 0.96, 95% CI = 0.55 to 1.69) after adjusting for age, severity of disease, comorbid status, and propensity score. These data do not support an independent association between current preadmission statin use and lower 30-day in-hospital mortality in emergency patients admitted with infection. This result is contrary to most previously published studies.

Long-Term Use of Statins and Risk of Colorectal Cancer

We conducted a population-based cohort study to determine the effect of long-term regular use of statins on the risk of colorectal cancer (CRC). Individuals who were dispensed statins regularly were identified from Manitoba's population-based prescription drug database and followed up until diagnosis of CRC, migration out of province, death, or December 2005. The incidence of CRC in this group was compared with that among individuals who were never dispensed statins. Stratified analysis was performed to determine the risk after 5 years of regular statin use. Multivariate Poisson regression models were used to adjust for potential confounding by age, sex, and history of diabetes, inflammatory bowel disease, coronary heart disease, lower gastrointestinal endoscopy, resective colorectal surgery, use of nonsteroidal anti-inflammatory drugs, hormone replacement therapy (among women), and median household income. The dose effect was evaluated in defined daily dose units. In total, 35,739 individuals were dispensed statins regularly. In all, 10,287 (49% males; 51% females) long-term (>or=5 years) regular statin users were followed up for up to 5 additional years. In multivariate analysis, the incidence rate ratio (IRR) of CRC among those dispensed statins regularly compared with those who were never dispensed statins (n=377,532) was 1.13 (95% confidence interval (CI): 1.02-1.25). The CRC risk among the long-term regular statin users was similar to that for individuals never dispensed statins (IRR, 0.89; 95% CI: 0.70-1.13). A statistically nonsignificant risk reduction was observed among high-dose long-term regular statin users. These findings suggest that long-term regular use of statins for the current clinical indications does not protect against CRC. The benefit of high-dose long-term statin use needs further evaluation.

Statin use in Canadians: trends, determinants and persistence.

Regular statin use is an important tool in chronic disease management, lowering cholesterol levels and reducing risk of cardiovascular disease (CVD). The objectives of this study are to describe statin use in Canada by comorbidity and lifestyle risk factors, and determine persistence in statin use. The longitudinal National Population Health Survey, 1994-2002, is a random sample of the 1994 Canadian population and five interviews were conducted at two-year intervals. A total of 8,198 respondents, aged 20 in 1994, completed all five interviews. Information collected included demographic variables, medication use, CVD lifestyle risk factors, CVD, diabetes and hypertension. Age-adjusted rates of statin use increased from 1.6% to 7.8% over the period 1994-2002. Statin use was higher with increasing age, diabetes, BMI, physician visits, and insurance for prescription medication. Although persons with CVD were more likely to take statins than those without, by 2002 still only 32.7% of heart patients were taking statins. Statin use did not increase linearly with increasing numbers of CVD risk factors or comorbidities. Of the 441 persons reporting statin use in 2000, 74.6% were still taking them in 2002. People who completed their high school education were more likely to continue taking statins than those who did not complete high school. While statin use increased over time, was associated with CVD and diabetes, and to a lesser extent with increased BMI, a substantive underuse in high-risk patients remains. Helping high-risk people to increase statin use continues to be a priority for health care professionals.

Statin Use and Tooth Loss in Chronic Periodontitis Patients

Statins have anti-inflammatory and bone stimulating properties that may positively affect chronic periodontitis. Our objective in this study was to evaluate whether statin use by chronic periodontitis patients had a beneficial impact on tooth loss. In a retrospective cohort study (N patients = 1,021; mean follow-up = 7.1 years), dental records were merged with pharmacy data. Any statin use during 3 years, statin use during each of 3 consecutive years (regular use), and any statin use during the first 3 years after the initial periodontal exam were evaluated as predictors of tooth loss using negative binomial regression models with adjustment for potential confounding factors. Any statin use during 3 years was not associated with tooth loss rate in the year subsequent to the 3-year period (rate ratio [RR] = 1.00; 95% confidence interval [CI] = 0.56 to 1.81). Regular statin use during 3 years was associated with a non-significant 37% reduced tooth loss rate in the year subsequent to the 3-year period (RR = 0.63; 95% CI = 0.32 to 1.25). Any statin use during the first 3 years after the initial periodontal exam was associated with a 48% decreased tooth loss rate in year 4 and subsequent years (RR = 0.52; 95% CI = 0.29 to 0.95). Our findings were mixed for an association of statin use with reduced tooth loss in chronic periodontitis patients. Lack of control for some potential confounders, particularly smoking, and evaluation of different patterns of statin usage hamper the interpretation of the results. Exploration of these findings in additional epidemiological studies may be worthwhile.

Statin Use and Risk of Lymphoid Neoplasms: Results from the European Case-Control Study EPILYMPH

Statins, drugs used to treat dyslipidemia, may have anticancer properties. We have evaluated lymphoma risk associated with regular statin use in an international case-control study. This case-control study included 2,362 cases of incident B- and T-cell lymphoma from Czech Republic, France, Germany, Ireland, Italy, and Spain and 2,206 hospital or population controls. Information on drug use, diagnosis at admission (for hospital controls), and putative risk factors for lymphoma was collected with personal interviews. Hospital controls admitted for diseases possibly entailing use of statins were excluded from the analysis. The odds ratio for regular statin use was 0.61 (95% confidence interval, 0.45-0.84); all major lymphoma subtypes showed similarly decreased risks. Decreased risks were observed in all centers. Duration of statin use was not associated with a greater reduction in the risk of lymphoma. Use of other lipid lowering drugs, such as fibrates, did not significantly modify the risk of lymphoma (odds ratio, 0.75; 95% confidence interval, 0.44-1.27). Statin use was associated with an important reduction in lymphoma risk, adding to the growing evidence of anticancer properties of this group of drugs. These results are reassuring for the increasing number of patients taking statins on a regular basis.