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Dix C, Dolan G, Hunt BJ. Reducing the risk of atherosclerotic cardiovascular disease in people with hemophilia: the importance of primary prevention. J Thromb Haemost 2024; 22:1304-1312. [PMID: 38309435 DOI: 10.1016/j.jtha.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/12/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
Revolutionary advances in the treatment of hemophilia has led to a significant improvement in life expectancy. Associated with this has been an increase in age-related diseases especially atherosclerotic cardiovascular disease (CVD). While people with hemophilia (PWH) develop atherosclerosis at rates similar to those of the general population, rates of atherothrombosis and mortality related to CVD have been much lower, due to their hypocoagulable state. Changing treatment paradigms, aimed at reducing the risk of bleeding by improving hemostasis to levels approaching normality, has meant that the protection they are thought to have had may be lost. CVD risk factors are just as common in PWH as in the general population, but appear to be undertreated. In particular, primary prevention of CVD is vital in all individuals, but particularly in PWH as treatment of established CVD can be difficult. Active identification and management of CVD risk factors, such as obesity, physical inactivity, hypertension, and hypercholesterolemia, is required. In particular, statins have been shown to significantly reduce cardiovascular and all-cause mortality with few adverse events and no increased risk of bleeding in the general population, and their use needs urgent assessment in PWH. Further longitudinal research into preventing CVD in PWH, including accurate CVD risk assessment, is required to optimize prevention and management.
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Affiliation(s)
- Caroline Dix
- Haemophilia & Thrombosis Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Gerry Dolan
- Haemophilia & Thrombosis Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Beverley J Hunt
- Haemophilia & Thrombosis Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK.
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Parolina de Carvalho RD, de Andrade Moreno J, Roque SM, Chan DCH, Torrez WB, Stipp RN, Bueno-Silva B, de Lima PO, Cogo-Müller K. Statins and oral biofilm: Simvastatin as a promising drug to control periodontal dysbiosis. Oral Dis 2024; 30:669-680. [PMID: 36416468 DOI: 10.1111/odi.14446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/10/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study evaluated antimicrobial activity of atorvastatin, pravastatin, rosuvastatin, and simvastatin against oral bacteria, and the interaction of simvastatin with standard antimicrobials (amoxicillin and metronidazole). METHODS Minimal inhibitory concentration assays were performed with Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinomyces odontolyticus, Streptococcus oralis, Streptococcus mitis, Streptococcus salivarius, Streptococcus sanguinis, and Streptococcus gordonii; checkerboard microdilution assays between simvastatin and standard antimicrobials; monospecies and multispecies biofilms. RESULTS Simvastatin showed the best antimicrobial activity against most species (MIC range from 3.12 to 25 μg/ml), highlighting the sensitivity of P. gingivalis. In the checkerboard assay, synergistic interaction was found between simvastatin and amoxicillin against S. oralis and S. sanguinis. P. gingivalis biofilm was inhibited by simvastatin at 10 and 50× Minimal inhibitory concentration, with similar effects to metronidazole. For multispecies biofilm, SMV reduced the biofilm metabolic activity (79%) and total counts (87%), comparable to amoxicillin. Simvastatin also reduced bacterial counts of Veilonnella parvula, P. gingivalis, Streptococcus mutans, Actinomyces naeslundii, P. intermedia, and Capnocytophaga ochracea in the multispecies biofilm. CONCLUSIONS Simvastatin showed antimicrobial and antibiofilm activity against oral bacteria and may contribute to the control of dysbiosis, and may be considered in clinical studies as an adjuvant in the treatment of periodontitis.
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Affiliation(s)
| | | | - Sindy Magri Roque
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
| | - Daniel Cheuk Hong Chan
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Willy Bustillos Torrez
- Dental Research Division, University of Guarulhos (UNG), Guarulhos, Brazil
- Research department, Universidad Franz Tamayo, Cochabamba, Bolivia
| | - Rafael Nóbrega Stipp
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Bruno Bueno-Silva
- Dental Research Division, University of Guarulhos (UNG), Guarulhos, Brazil
| | | | - Karina Cogo-Müller
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil
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Wang GHM, Morris E, Vouri SM, Keshwani S, Schmidt S, Pepine CJ, Smith SM. Modifiable statin characteristics associated with potential statin-related prescribing cascades. Pharmacotherapy 2023; 43:1307-1316. [PMID: 37771303 DOI: 10.1002/phar.2883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/11/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Abstract
STUDY OBJECTIVE Clinicians may prescribe new medications (marker drug) to treat statin-related (index drug) adverse events, constituting a prescribing cascade. We aimed to identify modifiable statin characteristics (intensity and individual statin agents) associated with lower risk of prescribing cascades to inform clinical decisions in the presence of statin-related adverse events. DESIGN A secondary analysis based on our previous work, a high-throughput sequence symmetry analysis screening for potential statin-related prescribing cascades. DATA SOURCE MarketScan Commercial and Medicare Supplemental Insurance claims databases between 2005 and 2019. PATIENTS Adults who initiated a statin between 2007 and 2018, and who were continuously enrolled in the same healthcare plan for at least 720 days before and 360 days after statin initiation. INTERVENTION Among the previously identified 57 potential prescribing cascades, 42 statin-marker class dyad with a sample size of ≥ 500 were assessed in this study. MEASUREMENTS We measured patients' baseline characteristics within -360 days of statin initiation and reported by modifiable statin characteristics. We also performed logistic regression and reported the adjusted odds ratios (aOR) with 95% confidence intervals (CI) of modifiable statin characteristics after adjusting for baseline characteristics. MAIN RESULTS We identified 1,307,867 statin initiators who met the study criteria (21% elderly, 52% female). Compared with patients initiating low-intensity statins, those initiating moderate- or high-intensity statins had significantly greater odds to develop 29 (69%) prescribing cascades, including antidiabetic drugs such as dipeptidyl peptidase 4 (DPP-4) inhibitors (aOR 1.22; 95% CI, 1.11-1.35) and glucagon-like peptide-1 (GLP-1) analogs (aOR 1.31; 95% CI, 1.16-1.47), and opioids (aOR 1.18; 95% CI, 1.13-1.23). Individual statin agent selection also had a differential effect on 34 (81%) of the prescribing cascades. For example, compared with simvastatin initiators, the probability of initiating osmotically acting laxatives was significantly higher for lovastatin initiators (aOR 1.09; 95% CI, 1.03-1.15) and significantly lower in atorvastatin initiators (aOR 0.92; 95% CI, 0.89-0.94). CONCLUSION Compared with low-intensity statins, high-intensity statins are associated with increased risk in many potential prescribing cascades, while the choice of individual statin agents affects the risk of prescribing cascades bidirectionally.
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Affiliation(s)
- Grace Hsin-Min Wang
- Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - Earl Morris
- Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, USA
- Center for Drug Evaluation and Safety, University of Florida, Gainesville, Florida, USA
| | - Scott M Vouri
- Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, USA
- Center for Drug Evaluation and Safety, University of Florida, Gainesville, Florida, USA
| | - Shailina Keshwani
- Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, USA
| | - Stephan Schmidt
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, Florida, USA
| | - Carl J Pepine
- Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, Florida, USA
| | - Steven M Smith
- Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, USA
- Center for Drug Evaluation and Safety, University of Florida, Gainesville, Florida, USA
- Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, Florida, USA
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Sun B, Yew PY, Chi CL, Song M, Loth M, Zhang R, Straka RJ. Development and application of pharmacological statin-associated muscle symptoms phenotyping algorithms using structured and unstructured electronic health records data. JAMIA Open 2023; 6:ooad087. [PMID: 37881784 PMCID: PMC10597587 DOI: 10.1093/jamiaopen/ooad087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/03/2023] [Accepted: 10/03/2023] [Indexed: 10/27/2023] Open
Abstract
Importance Statins are widely prescribed cholesterol-lowering medications in the United States, but their clinical benefits can be diminished by statin-associated muscle symptoms (SAMS), leading to discontinuation. Objectives In this study, we aimed to develop and validate a pharmacological SAMS clinical phenotyping algorithm using electronic health records (EHRs) data from Minnesota Fairview. Materials and Methods We retrieved structured and unstructured EHR data of statin users and manually ascertained a gold standard set of SAMS cases and controls using the published SAMS-Clinical Index tool from clinical notes in 200 patients. We developed machine learning algorithms and rule-based algorithms that incorporated various criteria, including ICD codes, statin allergy, creatine kinase elevation, and keyword mentions in clinical notes. We applied the best-performing algorithm to the statin cohort to identify SAMS. Results We identified 16 889 patients who started statins in the Fairview EHR system from 2010 to 2020. The combined rule-based (CRB) algorithm, which utilized both clinical notes and structured data criteria, achieved similar performance compared to machine learning algorithms with a precision of 0.85, recall of 0.71, and F1 score of 0.77 against the gold standard set. Applying the CRB algorithm to the statin cohort, we identified the pharmacological SAMS prevalence to be 1.9% and selective risk factors which included female gender, coronary artery disease, hypothyroidism, and use of immunosuppressants or fibrates. Discussion and Conclusion Our study developed and validated a simple pharmacological SAMS phenotyping algorithm that can be used to create SAMS case/control cohort to enable further analysis which can lead to the development of a SAMS risk prediction model.
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Affiliation(s)
- Boguang Sun
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN 55455, United States
| | - Pui Ying Yew
- Institute for Health Informatics, Office of Academic Clinical Affairs, University of Minnesota, Minneapolis, MN 55455, United States
| | - Chih-Lin Chi
- Institute for Health Informatics, Office of Academic Clinical Affairs, University of Minnesota, Minneapolis, MN 55455, United States
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, United States
| | - Meijia Song
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, United States
| | - Matt Loth
- Center for Learning Health System Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, United States
| | - Rui Zhang
- Institute for Health Informatics, Office of Academic Clinical Affairs, University of Minnesota, Minneapolis, MN 55455, United States
- Center for Learning Health System Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, United States
| | - Robert J Straka
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN 55455, United States
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Kim DH, Kim SW, Han JS, Kim GJ, Basurrah MA, Kim SH, Hwang SH. Are statins effective in preventing chronic rhinosinusitis? A systematic review and meta-analysis. Clin Otolaryngol 2023; 48:820-827. [PMID: 37648372 DOI: 10.1111/coa.14096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/06/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES To evaluate the association between statin use and chronic rhinosinusitis (CRS). DESIGN AND SETTING Systematic review and meta-analysis. The methodological quality of studies was assessed using the Newcastle-Ottawa scale. PARTICIPANTS Patients with CRS. MAIN OUTCOME MEASURES Pooled odds ratios (ORs) with 95% confidence interval (CIs) in analyses of studies that compared the prevalence of CRS, nasal polyp, difference of Lund-Kennedy endoscopic score, Lund-Mackay CT score and Sino-nasal Outcome Test-22. RESULTS The analysis included eight studies and 445 465 patients. Patients who used statins were at lower risk for CRS than those who did not (OR = 0.7457, 95% CI = 0.6629-0.8388, p < 0.0001, I2 = 0.0%). Patients with hyperlipidaemia were at higher risk for CRS than those with normal serum levels of lipid (OR = 1.3590, 95% CI = 1.2831-1.4394, p < 0.0001, I2 = 33.3%). However, there were no significant differences in the risk for nasal polyps between CRS patients using statins or not (OR = 1.0931, 95% CI = 0.7860-1.5202, p = 0.5968, I2 = 0.0%). Additionally, statin use was not related to Lund-Kennedy endoscopic scores, Lund-Mackay CT scores or sino-nasal outcome test-22 scores in CRS patients. CONCLUSION The risk for CRS is lower in patients who use statins and those without hyperlipidaemia.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Sang Han
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Geun-Jeon Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | | | - Sun Hong Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Ho HV, Patel H, Ahmed M, Eddib A, Oyesanmi O, Modi F, Sorresso D, Mhaskar R, Phrathep D. A Retrospective Cohort Study Assessing the Impact of Statin Therapy on Hospital Length of Stay and Inpatient Mortality in COVID-19 Patients. HCA Healthc J Med 2023; 4:369-375. [PMID: 37969853 PMCID: PMC10635693 DOI: 10.36518/2689-0216.1546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Background Coronaviruses, known for their crown-like appearance, cause mild gastrointestinal and respiratory diseases. Some cause outbreaks of respiratory diseases, most recently, SARS-CoV-2, the coronavirus disease 2019 (COVID-19). Individuals with COVID-19 are reported to be in both arterial and venous prothrombotic states. In addition to a lipid-lowering effect, statin also has an anti-inflammatory effect, which addresses one of the underlying causes of thrombosis. An in-silico study revealed that statins could directly interact with the main protease enzyme of SARS-CoV-2 and prevent infectivity. Due to these pleiotropic properties, statins may positively impact the outcome of hospitalized patients with COVID-19 infections. Methods A total of 26 445 acute COVID-19-infected patients were included in this study. Patients were stratified based on home statin use status: no statins, high-intensity statins (atorvastatin 40-80 mg daily and rosuvastatin 20-40 mg daily), and low-to-moderate intensity statins (all other statins). A multivariate generalized linear model and logistic regression were used to predict the hospital length of stay and inpatient mortality, respectively. Results The hospital length of stay was compared between low-intensity and high-intensity statin use against no statin therapy. The length of stay was 3.88 days (95% CI, 3.56-4.20; P < .0001) longer among patients with low-dose statin therapy compared to patients without. The length of stay was 4.77 days (95% CI, 4.42-5.13; P <.0001) longer among patients with high-intensity statin therapy than those without. The odds of in-hospital mortality decreased by 24% (OR, 0.76; 95% CI, 0.76-0.97) among those with high-dose statin therapy compared to patients without (P = .02). There was no statistical significance between the low-dose statin group and the no statin group for inpatient mortality. Conclusion Hospitalized COVID-19 patients on statin therapy, regardless of intensity, are more likely to have a longer length of stay. There may be a mortality benefit in using high-intensity statin in acute COVID-19-infected patients. The results of this study are insufficient to recommend statin therapy for inpatient COVID-19 treatment. However, patients with significant cardiovascular comorbidities, where statins are indicated, should be on these medications, especially amidst the COVID-19 pandemic. Randomized controlled trials are needed to assess the potential in-hospital benefit of statin therapy on COVID-19 patients.
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Affiliation(s)
- Huy V Ho
- HCA Healthcare/USF Morsani College of Medicine Graduate Medical Education
- HCA Florida Citrus Hospital, Inverness, FL
| | - Hamish Patel
- HCA Healthcare/USF Morsani College of Medicine Graduate Medical Education
- HCA Florida Bayonet Point Hospital, Hudson, FL
| | - Mohammed Ahmed
- HCA Healthcare/USF Morsani College of Medicine Graduate Medical Education
- HCA Florida Citrus Hospital, Inverness, FL
| | - Ahmed Eddib
- HCA Healthcare/USF Morsani College of Medicine Graduate Medical Education
- HCA Florida Citrus Hospital, Inverness, FL
| | - Olugbenga Oyesanmi
- HCA Healthcare/USF Morsani College of Medicine Graduate Medical Education
| | - Fagunkumar Modi
- HCA Healthcare/USF Morsani College of Medicine Graduate Medical Education
- HCA Florida Citrus Hospital, Inverness, FL
| | - Domenick Sorresso
- HCA Healthcare/USF Morsani College of Medicine Graduate Medical Education
- HCA Florida Bayonet Point Hospital, Hudson, FL
| | - Rahul Mhaskar
- Office of Research, Innovation and Scholarly Endeavors, University of South Florida College of Medicine, Tampa, FL
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Wang AY, Lin GL, Keller JJ, Wang LH. Association between antihyperlipidemic agents and the risk of chronic periodontitis in patients with hyperlipidemia: A population-based retrospective cohort study in Taiwan. J Periodontol 2023. [PMID: 37793052 DOI: 10.1002/jper.23-0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/23/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The lipid-lowering and anti-inflammatory effects of statins and fibrates may ameliorate periodontitis. Patients with hyperlipidemia tend to have a worse periodontal status. This study assessed the association between the use of statins/fibrates and the incidence of chronic periodontitis in patients with hyperlipidemia in Taiwan. METHODS This retrospective cohort study enrolled patients newly diagnosed with hyperlipidemia between 2001 and 2012 from the 2000 Longitudinal Generation Tracking Database and followed them for 5 years. The study population was divided into four groups: statin monotherapy, fibrate monotherapy, combination therapy (both statins and fibrates), and control (neither statins nor fibrates). Each patient in the treatment group was matched at a ratio of 1:1 with a control. Chronic periodontitis risk was compared in the three study arms by using a Cox proportional hazard model. RESULTS Chronic periodontitis risk was reduced by 25.7% in the combination therapy group compared with the control group (adjusted hazard ratio [aHR], 0.743; 95% confidence interval (CI), 0.678-0.815). Low dose (<360 cumulative defined daily dose [cDDD]) and shorter duration (<2 years) of statin monotherapy seem to be associated with an increased risk of chronic periodontitis; high dose (≥720 cDDD/≥1080 cDDD) and longer duration (≥3 years) of statin/fibrate monotherapy may be correlated with a lower risk of periodontitis. Hydrophobic statin users had a lower chronic periodontitis risk than hydrophilic statin users. CONCLUSION Chronic periodontitis risk was lower in patients with hyperlipidemia on combination treatment with statins and fibrates, and the risk decreased when patients used statins or fibrates for >3 years.
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Affiliation(s)
- An-Yi Wang
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Guan-Ling Lin
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Joseph Jordan Keller
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
| | - Li-Hsuan Wang
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan
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Goldstein LB, Toth PP, Dearborn-Tomazos JL, Giugliano RP, Hirsh BJ, Peña JM, Selim MH, Woo D. Aggressive LDL-C Lowering and the Brain: Impact on Risk for Dementia and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol 2023; 43:e404-e442. [PMID: 37706297 DOI: 10.1161/atv.0000000000000164] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
The objective of this scientific statement is to evaluate contemporary evidence that either supports or refutes the conclusion that aggressive low-density lipoprotein cholesterol lowering or lipid lowering exerts toxic effects on the brain, leading to cognitive impairment or dementia or hemorrhagic stroke. The writing group used literature reviews, references to published clinical and epidemiology studies, clinical and public health guidelines, authoritative statements, and expert opinion to summarize existing evidence and to identify gaps in current knowledge. Although some retrospective, case control, and prospective longitudinal studies suggest that statins and low-density lipoprotein cholesterol lowering are associated with cognitive impairment or dementia, the preponderance of observational studies and data from randomized trials do not support this conclusion. The risk of a hemorrhagic stroke associated with statin therapy in patients without a history of cerebrovascular disease is nonsignificant, and achieving very low levels of low-density lipoprotein cholesterol does not increase that risk. Data reflecting the risk of hemorrhagic stroke with lipid-lowering treatment among patients with a history of hemorrhagic stroke are not robust and require additional focused study.
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Michalek IM, Graff RE, Sanchez A, Choueiri TK, Cho E, Preston MA, Wilson KM. Evaluation of statin use and renal cell carcinoma risk identifies sex-specific associations with RCC subtypes. Acta Oncol 2023; 62:988-993. [PMID: 37482537 DOI: 10.1080/0284186x.2023.2238883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
Background: The association between statin use and risk of renal cell carcinoma (RCC) has been debated. We aimed to evaluate whether statin use is associated with RCC risk.Material and methods: We studied 100,195 women in the Nurses' Health Study (NHS) from 1994 to 2016; 91,427 women in the Nurses' Health Study II (NHS II) from 1999 to 2015; and 45,433 men in the Health Professionals Follow-up Study (HPFS) from 1990 to 2016. Statins and covariate data were collected at baseline and then biennially. Outcome was measured as incidence of total RCC and clinically relevant disease subgroups. Cox proportional hazards models estimated covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).Results: During follow-up, 661 participants developed RCC. There was no significant association between the use of statins and the risk of overall RCC, fatal RCC, or advanced or localized disease. Across cohorts, the adjusted HR for ever vs. never users was 0.97 (95% CI 0.81-1.16). Female ever users of statins were at increased risk of high-grade disease in the NHS only (HR 1.75, 95% CI 1.07-2.85). Among men only, ≥4 years of statin use was associated with an increased risk of clear cell RCC (HR 1.65, 95% CI 1.10-2.47).Conclusions: Statin use was not associated with the overall risk of RCC. However, it was associated with an increased risk of high-grade disease among women in the NHS cohort and an increased risk of clear cell RCC among men. The reasons for these inconsistent results by sex are unclear.
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Affiliation(s)
- Irmina Maria Michalek
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warsaw, Poland
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rebecca E Graff
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Alejandro Sanchez
- Division of Urology, Department of Surgery, Huntsman Cancer Institute and University of Utah, Salt Lake City, UT, USA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, The Lank Center for Genitourinary Oncology, Boston, MA, USA
| | - Eunyoung Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Mark A Preston
- Division of Urology, Brigham and Women's Hospital, Boston, MA, USA
| | - Kathryn M Wilson
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Matsumoto A, Yoshimura Y, Nagano F, Bise T, Kido Y, Shimazu S, Shiraishi A. Statin use impairs muscle strength recovery in post-stroke patients with sarcopenia. Geriatr Gerontol Int 2023; 23:676-683. [PMID: 37485543 DOI: 10.1111/ggi.14646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/29/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023]
Abstract
AIM The effects of statins on muscle health are not well established. Therefore, this study investigated the impact of statin use on muscle strength and mass recovery in patients with sarcopenia after stroke. METHODS This retrospective cohort study included stroke patients with sarcopenia hospitalized between 2015 and 2021 at a post-acute rehabilitation hospital. Sarcopenia was diagnosed using handgrip strength and skeletal muscle mass index measured using bioelectrical impedance analysis according to the 2019 criteria of the Asian Working Group for Sarcopenia. The study outcomes included handgrip strength and skeletal muscle mass index at hospital discharge. We used multivariate analyses to examine whether statin use was independently associated with the outcomes. Statistical significance was set at P < 0.05. RESULTS Of the 586 patients enrolled, 241 (mean age 79.3 years, 44.4% men) presented with sarcopenia and were included in the analysis. Statin use was observed in 61 (25.3%) patients. Statin use was independently negatively associated with handgrip strength at discharge (β = -0.095, P = 0.032), but not with skeletal muscle mass index at discharge (β = 0.019, P = 0.692). CONCLUSIONS Statin use was negatively associated with muscle strength recovery, but not with muscle mass in patients with sarcopenia who underwent rehabilitation after stroke. To maximize outcomes, sufficient consideration is needed for statin use in these patients. Geriatr Gerontol Int 2023; 23: 676-683.
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Affiliation(s)
- Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Takahiro Bise
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoshifumi Kido
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Sayuri Shimazu
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Ai Shiraishi
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
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Morinaga J, Kashiwabara K, Torigoe D, Okadome Y, Aizawa K, Uemura K, Kurashima A, Matsunaga E, Fukami H, Horiguchi H, Sato M, Sugizaki T, Miyata K, Kadomatsu T, Mukoyama M, Miyauchi K, Hokimoto S, Fukumoto Y, Hiro T, Hibi K, Nakagawa Y, Sakuma I, Ozaki Y, Iwata H, Iimuro S, Daida H, Shimokawa H, Kimura T, Matsuzaki M, Saito Y, Matsuyama Y, Nagai R, Oike Y. Plasma ANGPTL8 Levels and Risk for Secondary Cardiovascular Events in Japanese Patients With Stable Coronary Artery Disease Receiving Statin Therapy. Arterioscler Thromb Vasc Biol 2023; 43:1549-1559. [PMID: 37259862 DOI: 10.1161/atvbaha.122.318880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND The ability to predict secondary cardiovascular events could improve health of patients undergoing statin treatment. Circulating ANGPTL8 (angiopoietin-like protein 8) levels, which positively correlate with proatherosclerotic lipid profiles, activate the pivotal proatherosclerotic factor ANGPTL3. Here, we assessed potential association between circulating ANGPTL8 levels and risk of secondary cardiovascular events in statin-treated patients. METHODS We conducted a biomarker study with a case-cohort design, using samples from a 2018 randomized control trial known as randomized evaluation of high-dose (4 mg/day) or low-dose (1 mg/day) lipid-lowering therapy with pitavastatin in coronary artery disease (REAL-CAD [Randomized Evaluation of Aggressive or Moderate Lipid-Lowering Therapy With Pitavastatin in Coronary Artery Disease])." From that study's full analysis set (n=12 413), we selected 2250 patients with stable coronary artery disease (582 with the primary outcome, 1745 randomly chosen, and 77 overlapping subjects). A composite end point including cardiovascular-related death, nonfatal myocardial infarction, nonfatal ischemic stroke, or unstable angina requiring emergent admission was set as a primary end point. Circulating ANGPTL8 levels were measured at baseline and 6 months after randomization. RESULTS Over a 6-month period, ANGPTL8 level changes significantly decreased in the high-dose pitavastatin group, which showed 19% risk reduction of secondary cardiovascular events compared with the low-dose group in the REAL-CAD [Randomized Evaluation of Aggressive or Moderate Lipid-Lowering Therapy With Pitavastatin in Coronary Artery Disease] study. In the highest quartiles, relative increases in ANGPTL8 levels were significantly associated with increased risk for secondary cardiovascular events, after adjustment for several cardiovascular disease risk factors and pitavastatin treatment (hazard ratio in Q4, 1.67 [95% CI, 1.17-2.39). Subgroup analyses showed relatively strong relationships between relative ANGPTL8 increases and secondary cardiovascular events in the high-dose pitavastatin group (hazard ratio in Q4, 2.07 [95% CI, 1.21-3.55]) and in the low ANGPTL8 group at baseline (166 CONCLUSIONS Monitoring ANGPTL8 levels over time might be useful to assess residual risk of cardiovascular secondary events in patients with cardiovascular disease undergoing statin therapy.
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Affiliation(s)
- Jun Morinaga
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
- Department of Nephrology (J.M., A.K., E.M., H.F., M.M.), Graduate School of Medical Sciences, Kumamoto University, Japan
- Department of Clinical Investigation, Kumamoto University Hospital, Japan (J.M.)
| | - Kosuke Kashiwabara
- Data Science Office, Clinical Research Promotion Center, The University of Tokyo Hospital, Japan (K.K.)
| | - Daisuke Torigoe
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Yusuke Okadome
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Kenichi Aizawa
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Tochigi, Japan (K.A.)
| | - Kohei Uemura
- Department of Biostatistics and Bioinformatics, Interfaculty Initiative in Information Studies (K.U.), The University of Tokyo, Japan
| | - Ai Kurashima
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
- Department of Nephrology (J.M., A.K., E.M., H.F., M.M.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Eiji Matsunaga
- Department of Nephrology (J.M., A.K., E.M., H.F., M.M.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Hirotaka Fukami
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
- Department of Nephrology (J.M., A.K., E.M., H.F., M.M.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Haruki Horiguchi
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Michio Sato
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Taichi Sugizaki
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Keishi Miyata
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Tsuyoshi Kadomatsu
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Masashi Mukoyama
- Department of Nephrology (J.M., A.K., E.M., H.F., M.M.), Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Katsumi Miyauchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (K.M., H.I., H.D.)
| | | | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan (Y.F.)
| | - Takafumi Hiro
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (T.H.)
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center, Japan (K.H.)
| | - Yoshihisa Nakagawa
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan (Y.N.)
| | | | - Yukio Ozaki
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.)
| | - Hiroshi Iwata
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (K.M., H.I., H.D.)
| | - Satoshi Iimuro
- Innovation and Research Support Center, International University of Health and Welfare, Tokyo, Japan (S.I.)
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (K.M., H.I., H.D.)
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan (H.S.)
- International University of Health and Welfare, Narita, Japan (H.S.)
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan (T.K.)
| | | | | | - Yutaka Matsuyama
- Department of Biostatistics, School of Public Health, Graduate School of Medicine (Y.M.), The University of Tokyo, Japan
| | - Ryozo Nagai
- Jichi Medical University, Shimotsuke, Japan (R.N.)
| | - Yuichi Oike
- Department of Molecular Genetics (J.M., D.T., Y. Okadome., A.K., E.M., H.F., H.H., M.S., T.S., K.M., T.K. Y. Oike),, Graduate School of Medical Sciences, Kumamoto University, Japan
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Virani SS, Ramsey DJ, Westerman D, Kuebeler MK, Chen L, Akeroyd JM, Gobbel GT, Ballantyne CM, Petersen LA, Turchin A, Matheny ME. Cluster Randomized Trial of a Personalized Clinical Decision Support Intervention to Improve Statin Prescribing in Patients With Atherosclerotic Cardiovascular Disease. Circulation 2023; 147:1411-1413. [PMID: 36871214 DOI: 10.1161/circulationaha.123.064226] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Salim S Virani
- Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center, Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX (S.S.V., D.J.R., M.K.K., J.M.A., L.A.P.)
- Section of Cardiovascular Research (S.S.V., C.M.B.), Department of Medicine, Baylor College of Medicine, Houston, TX
- The Aga Khan University, Karachi, Pakistan (S.S.V.)
| | - David J Ramsey
- Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center, Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX (S.S.V., D.J.R., M.K.K., J.M.A., L.A.P.)
| | - Dax Westerman
- Geriatrics Research Education and Clinical Care, Tennessee Valley Healthcare System VA, Nashville (D.W., G.T.G., M.E.M.)
- Departments of Biomedical Informatics, Biostatistics, and Medicine, Vanderbilt University Medical Center, Nashville, TN (D.W., G.T.G., M.E.M.)
| | - Mark K Kuebeler
- Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center, Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX (S.S.V., D.J.R., M.K.K., J.M.A., L.A.P.)
| | | | - Julia M Akeroyd
- Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center, Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX (S.S.V., D.J.R., M.K.K., J.M.A., L.A.P.)
| | - Glenn T Gobbel
- Geriatrics Research Education and Clinical Care, Tennessee Valley Healthcare System VA, Nashville (D.W., G.T.G., M.E.M.)
- Departments of Biomedical Informatics, Biostatistics, and Medicine, Vanderbilt University Medical Center, Nashville, TN (D.W., G.T.G., M.E.M.)
| | - Christie M Ballantyne
- Section of Cardiovascular Research (S.S.V., C.M.B.), Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Laura A Petersen
- Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center, Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX (S.S.V., D.J.R., M.K.K., J.M.A., L.A.P.)
- Section of Health Services Research (L.A.P.), Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Alexander Turchin
- Harvard Medical School, Boston, MA (A.T.)
- Division of Endocrinology, Brigham and Women's Hospital, Boston, MA (A.T.)
| | - Michael E Matheny
- Geriatrics Research Education and Clinical Care, Tennessee Valley Healthcare System VA, Nashville (D.W., G.T.G., M.E.M.)
- Departments of Biomedical Informatics, Biostatistics, and Medicine, Vanderbilt University Medical Center, Nashville, TN (D.W., G.T.G., M.E.M.)
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Lee K, Noh E, Moon SJ, Joo YY, Kang EJ, Seo JH, Park IH. Statin use in patients with hormone receptor-positive metastatic breast cancer treated with everolimus and exemestane. Cancer Med 2023; 12:5461-5470. [PMID: 36263515 PMCID: PMC10028110 DOI: 10.1002/cam4.5369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/19/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND We analyzed the effect of statins in patients with hormone receptor-positive (HR+) metastatic breast cancer treated with everolimus + exemestane (EverX). MATERIALS AND METHODS We conducted a nationwide retrospective cohort study using the National Health Insurance database with patients who received EverX for metastatic breast cancer between 2011 and 2019. RESULTS Of 224,948 patients diagnosed with breast cancer, 1749 patients who received EverX for at least 30 days were included. Among them, 500 (28.6%) patients were found to take statins with EverX treatment (statin group), and the median duration of this combination was 5.36 months. The median time to treatment duration (TTD) for EverX and the overall survival (OS) were significantly higher in the statin group than in the no-statin group [7.69 vs. 5.06 months, p < 0.001; 45.7 vs. 26.0 months, p < 0.001, respectively]. Multivariable Cox analysis revealed that the use of statins was associated with prolonged TTD [HR = 0.67 (95% CI, 0.59-0.77)] and OS [HR = 0.57 (95% CI, 0.46-0.70)] for EverX even after adjustment for other covariates. CONCLUSION Statins may have synergistic effects with endocrine therapy with the mTOR inhibitor everolimus, and improve survival in patients with HR+ metastatic breast cancer.
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Affiliation(s)
- Kyoungmin Lee
- Division of Hemato-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eunjin Noh
- Smart Healthcare Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seok Joo Moon
- Smart Healthcare Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | | | - Eun Joo Kang
- Division of Hemato-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae Hong Seo
- Division of Hemato-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - In Hae Park
- Division of Hemato-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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14
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Jaam M, Al-Naimi HN, Haddad MM, Abushanab D, Al-Badriyeh D. Comparative efficacy and safety among high-intensity statins. Systematic Review and Meta-Analysis. J Comp Eff Res 2023; 12:e220163. [PMID: 36847307 PMCID: PMC10288954 DOI: 10.57264/cer-2022-0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/05/2022] [Indexed: 03/01/2023] Open
Abstract
Aim: To summarize the evidence in terms of efficacy and safety of head-to-head studies of high-intensity statins regardless of the underlying population. Materials & methods: A systematic review and meta-analysis was conducted to summarize the effect sizes in randomized controlled trials and cohort studies that compared high-intensity statins. Results: Based on 44 articles, similar effectiveness was observed across the statins in reducing LDL levels from baseline. All statins were observed to have similar adverse drug reactions (ADRs), although higher dosages were associated with more ADRs. Based on a pooled quantitative analysis of atorvastatin 80 mg versus rosuvastatin 40 mg, rosuvastatin was statistically more effective in reducing LDL. Conclusion: This review further confirms that high-intensity statins reduce LDL by ≥50%, favoring rosuvastatin over atorvastatin. Additional data are needed to confirm the clinical significance on cardiovascular outcomes using real-world studies.
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Affiliation(s)
- Myriam Jaam
- College of Pharmacy, QU Health, Qatar University, Doha, 2713, Qatar
| | | | | | - Dina Abushanab
- Drug Information Department, Hamad Medical Corporation, Doha, 3050, Qatar
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, 3052, Australia
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15
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Yulian ED, Siregar NC, Sudijono B, Hwei LRY. The role of HMGCR expression in combination therapy of simvastatin and FAC treated locally advanced breast cancer patients. Breast Dis 2023; 42:73-83. [PMID: 36938720 DOI: 10.3233/bd-220021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Several studies have shown the role of statin added to the patient's chemotherapy regimen and the role of Hydroxymethylglutaryl-CoA Reductase (HMGCR) expression in predicting breast cancer patient outcomes. In our previous study, adding statins improved clinical and pathological responses in LABC patients. Furthermore, we planned to study statin's role as a combination to neoadjuvant chemotherapy (NAC) in treating locally advanced breast cancers on the basis of HMGCR expression. Moreover, we aimed to study the association between the patients' clinicopathological characteristics and HMGCR expression. METHODS This study is a randomized, double-blinded, placebo-controlled trial in two health centers in Indonesia. Each patient enrolled with written informed consent and then randomized to receive either simvastatin 40 mg/day or a placebo, combined with the fluorouracil, adriamycin, and cyclophosphamide (FAC) NAC. RESULTS HMGCR was associated with low staging and normal serum cholesterol in the high Ki67 level group (p = 0.042 and p = 0.021, respectively). The pre-and post-chemotherapy tumor sizes are significantly correlated in two groups (HMGCR negative expression, p = 0.000 and HMGCR moderate expression, p = 0.001) with a more considerable average decrease in tumor size compared to HMGCR strong expression group. CONCLUSION Statin therapy might work better in HMGCR-negative or low-expression tumors, although HGMCR expression is associated with better clinical parameters in our study.
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Affiliation(s)
- Erwin Danil Yulian
- Division of Surgical Oncology, Department of Surgery, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Nurjati Chairani Siregar
- Department of Pathology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Lie Rebecca Yen Hwei
- Division of Surgical Oncology, Department of Surgery, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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16
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Baumeister SE, Holtfreter B, Reckelkamm SL, Kocher T, Alayash Z, Ehmke B, Baurecht H, Nolde M. Genotype-driven NPC1L1 and PCSK9 inhibition and reduced risk of periodontitis. J Clin Periodontol 2023; 50:114-120. [PMID: 36054135 DOI: 10.1111/jcpe.13719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/02/2022] [Accepted: 08/16/2022] [Indexed: 12/24/2022]
Abstract
AIM Epidemiological and pre-clinical studies suggest a chemoprotective role of lipid-lowering agents in periodontitis. We tested the association of genetically proxied inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), Niemann-Pick C1-Like 1 (NPC1L1) and proprotein convertase subtilisin/kexin type 9 (PCSK9) with periodontitis. MATERIALS AND METHODS Genetic variants in HMGCR, NCP1L1 and PCSK9 associated with low-density lipoprotein (LDL) cholesterol in a genome-wide association study (GWAS) meta-analysis (N = 188,578) were used to proxy therapeutic inhibition of HMGCR, NPC1L1 and PCSK9. For these genetic variants, associations with periodontitis were obtained from GWAS of 17,353 cases and 28,210 controls in the GeneLifestyle Interactions in Dental Endpoints consortium. Generalized weighted least squares analysis accounted for linkage disequilibrium of genotypes to derive pooled estimates. RESULTS While genetically proxied HMGCR inhibition equivalent to 1 mmol/L reduction in LDL was not associated with odds of periodontitis (odds ratio [OR] = 0.92 [95% confidence interval [CI]: 0.73; 1.16]; p = .4905; false discovery rate [FDR] = 0.4905), genetically proxied NPC1L1 (OR = 0.53 [95% CI: 0.35; 0.81]; p = .0038; FDR = 0.0077) and PCSK9 (OR = 0.84 [95% CI: 0.74; 0.95]; p = .0051; FDR = 0.0077) inhibition lowered the odds of periodontitis. CONCLUSIONS Genetically proxied inhibition of NCP1L1 and PCSK9 was associated with lower odds of periodontitis.
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Affiliation(s)
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Lars Reckelkamm
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Zoheir Alayash
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Benjamin Ehmke
- Clinic for Periodontology and Conservative Dentistry, University of Münster, Münster, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Michael Nolde
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
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Lee J, Kim MH, Lee JM, Chang SA. Does Pitavastatin Therapy for Patients with Type 2 Diabetes and Dyslipidemia Affect Serum Adiponectin Levels and Insulin Sensitivity? J Clin Med 2022; 11. [PMID: 36431233 DOI: 10.3390/jcm11226756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: We aimed to demonstrate the effects of pitvastatin therapy on the serum levels of total adiponectin and high-molecular-weight (HMW) adiponectin in type 2 diabetes and the correlation with insulin sensitivity. (2) Methods: This study was designed as an open-labelled randomized trial. Patients with diabetes who were prescribed pitavastatin therapy were enrolled and randomized to either treatment with 2 mg of pitavastatin once daily (n = 44) (PITA group) or diet and exercise only, except their antidiabetic medications (n = 49), for 24 weeks. (3) Results: In lipid profiles, the reduction in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) was significantly increased in the PITA group (TC; 207.5 ± 20 vs. 195.5 ± 30.0 ng/dL, p < 0.001, LDL-C; 132.0 ± 15.8 vs. 123.1 ± 25.7 mg/dL, p < 0.001). Adiponectin and HMW adiponectin were elevated in the PITA group, compared to the control group without significance. The PITA group showed a lower level of HOMA-IR and HOMA-β levels. However, there was no significance (HOMA-IR; p = 0.5921 -at 12 weeks and p = 0.3645 at 24 weeks; HOMA-β; p = 0.8915 at 12 weeks and p = 0.7313 in 6 months). (4) Conclusions: The present study did not show a significant change in serum adiponectin or HMW adiponectin from baseline in serum adiponectin following pitavastatin therapy. Although statin has been considered as a risk for dysglycemia, pitavastatin did not affect insulin sensitivity.
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Trimarco V, Izzo R, Morisco C, Mone P, Manzi MV, Falco A, Pacella D, Gallo P, Lembo M, Santulli G, Trimarco B. High HDL (High-Density Lipoprotein) Cholesterol Increases Cardiovascular Risk in Hypertensive Patients. Hypertension 2022; 79:2355-2363. [PMID: 35968698 PMCID: PMC9617028 DOI: 10.1161/hypertensionaha.122.19912] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Emerging evidence suggests that elevated circulating levels of HDL-C (high-density lipoprotein cholesterol) could be linked to an increased mortality risk. However, to the best of our knowledge, the relationship between HDL-C and specific cardiovascular events has never been investigated in patients with hypertension. METHODS To fill this knowledge gap, we analyzed the relationship between HDL-C levels and cardiovascular events in hypertensive patients within the Campania Salute Network in Southern Italy. RESULTS We studied 11 987 patients with hypertension, who were followed for 25 534 person-years. Our population was divided in 3 groups according to the HDL-C plasma levels: HDL-C<40 mg/dL (low HDL-C); HDL-C between 40 and 80 mg/dL (medium HDL-C); and HDL-C>80 mg/dL (high HDL-C). At the follow-up analysis, adjusting for potential confounders, we observed a total of 245 cardiovascular events with a significantly increased risk of cardiovascular events in the low HDL-C group and in the high HDL-C arm compared with the medium HDL-C group. The spline analysis revealed a nonlinear U-shaped association between HDL-C levels and cardiovascular outcomes. Interestingly, the increased cardiovascular risk associated with high HDL-C was not confirmed in female patients. CONCLUSIONS Our data demonstrate that there is a U-shaped association between HDL-C and the risk of cardiovascular events in male patients with hypertension.
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Affiliation(s)
| | | | - Carmine Morisco
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy; International Translational Research and Medical Education (ITME) Consortium, Naples, Italy
| | - Pasquale Mone
- Division of Cardiology, Department of Medicine, Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York City, NY
| | - Maria Virginia Manzi
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
| | - Angela Falco
- Department of Neuroscience, Reproductive Sciences and Dentistry, “Federico II” University, Naples, Italy
| | - Daniela Pacella
- Department of Public Health, “Federico II” University, Naples, Italy
| | - Paola Gallo
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
| | - Maria Lembo
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy
| | - Gaetano Santulli
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy; International Translational Research and Medical Education (ITME) Consortium, Naples, Italy; Division of Cardiology, Department of Medicine, Wilf Family Cardiovascular Research Institute, Department of Molecular Pharmacology, Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York City, NY
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy; International Translational Research and Medical Education (ITME) Consortium, Naples, Italy
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19
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Weisskopf MG, Levy J, Dickerson AS, Paganoni S, Leventer-Roberts M. Statin Medications and Amyotrophic Lateral Sclerosis Incidence and Mortality. Am J Epidemiol 2022; 191:1248-1257. [PMID: 35333291 PMCID: PMC9393061 DOI: 10.1093/aje/kwac054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 01/26/2023] Open
Abstract
Studies of statins and amyotrophic lateral sclerosis (ALS) incidence and survival have had conflicting findings possibly related to difficulties with confounding by indication. We considered potency of statins used and duration of use to explore confounding by indication. Within the Clalit Health Services in Israel, we identified 948 ALS case patients from 2004 through 2017 and matched them with 1,000 control subjects each. Any statin use up to 3 years before ALS onset was not associated with ALS incidence but was associated with a reduced hazard ratio (HR) for death. Odds of ALS did not vary by statin potency, but use of only lower-potency statins was associated with longer survival (HR = 0.82, 95% CI: 0.68, 0.98), whereas the association with higher-potency statins was null compared with those case patients who did not use statins. However, duration of statin use appeared to account for these findings. Those who used statins only up to 3 years had longer survival (HR = 0.77, 95% CI: 0.61, 0.96) than did case patients who did not use statins, but those who used statins for >3 years did not. Although other explanations are possible, these findings could suggest a protective effect of statins on ALS survival that is partially masked by a worse prognosis from underlying reasons for taking statins that deserves further exploration.
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Affiliation(s)
- Marc G Weisskopf
- Correspondence to Marc Weisskopf, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue Building 1, Suite 1402, Boston, MA 02115 (e-mail: )
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20
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Chen W, Ochs-Balcom HM, Ma C, Isackson PJ, Vladutiu GD, Luzum JA. Coenzyme Q10 supplementation for the treatment of statin-associated muscle symptoms. Future Cardiol 2022; 18:461-470. [PMID: 35297269 PMCID: PMC9171566 DOI: 10.2217/fca-2021-0106] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim: To determine the association of coenzyme Q10 (CoQ10) use with the resolution of statin-associated muscle symptoms (SAMS). Patients & methods: Retrospective analysis of a large, multicenter survey study of SAMS (total n = 511; n = 64 CoQ10 users). Univariate and multivariate logistic regression models assessed the association between CoQ10 use and the resolution of SAMS. Results: The frequency of SAMS resolution was similar between CoQ10 users and non-users (25% vs 31%, respectively; unadjusted odds ratio [OR]: 0.75 [95% CI: 0.41-1.38]; p = 0.357). Similarly, CoQ10 use was not significantly associated with the resolution of SAMS in multivariable models adjusted for SAMS risk factors (OR: 0.84 [95% CI: 0.45-1.55]; p = 0.568) or adjusted for significant differences among CoQ10 users and non-users (OR: 0.82 [95% CI: 0.45-1.51]; p = 0.522). Conclusion: CoQ10 was not significantly associated with the resolution of SAMS.
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Affiliation(s)
- Wilson Chen
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USA
| | - Heather M Ochs-Balcom
- Department of Epidemiology & Environmental Health, School of Public Health & Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Changxing Ma
- Department of Biostatistics, School of Public Health & Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Paul J Isackson
- Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Georgirene D Vladutiu
- Department of Pediatrics, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA,Department of Neurology, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA,Department of Pathology & Anatomical Sciences, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Jasmine A Luzum
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USA,Author for correspondence: Tel.: +1 734 615 4851;
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21
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Howard J, Rajasundaram S. Role of Blinding in N-of-1 Trials. Circ Cardiovasc Qual Outcomes 2022; 15:e008914. [PMID: 35698975 DOI: 10.1161/circoutcomes.122.008914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- James Howard
- National Heart and Lung Institute, Imperial College London, United Kingdom (J.H., S.R.)
| | - Skanda Rajasundaram
- National Heart and Lung Institute, Imperial College London, United Kingdom (J.H., S.R.)
- Centre for Evidence-Based Medicine, University of Oxford, United Kingdom (S.R.)
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22
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Meregildo-Rodriguez ED, Chunga-Chévez EV, Gianmarco RAL, Vásquez-Tirado GA. Further insights into to the role of statins against active tuberculosis: systematic review and meta-analysis. Infez Med 2022; 30:194-203. [PMID: 35693063 PMCID: PMC9177183 DOI: 10.53854/liim-3002-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Tuberculosis is a major cause of global morbidity and mortality. Statins could be associated with a lower risk of some infectious diseases, including tuberculosis. Statins could reduce the risk of latent tuberculosis infection and active tuberculosis, acting as an adjuvant in treating tuberculosis. This study aimed to determine if statins reduce the risk of active tuberculosis. METHODS We systematically analyzed 8 databases from inception to December 2021. We included articles without language restriction if they met our inclusion and exclusion criteria and the PECO strategy (Population: adults without active pulmonary tuberculosis; Exposure: treatment with any statin; Comparator: no use of statins; Outcome: active tuberculosis). Odds Ratios (ORs) with 95% confidence intervals (CIs) were pooled using random- effects models regardless of heterogeneity quantified by Cochran's Q and I2 statistics. We performed subgroup analyses according to the participants' diabetic status and follow-up length (≤10 years or >10 years). RESULTS Twelve articles reporting observational studies involving 3.038.043 participants, including at least 32.668 cases of active tuberculosis. Eight reported retrospective cohort studies, three nested case-control study, and one was a case control study.According to our meta-analysis, statins may reduce the risk of active tuberculosis, in the general population (OR 0.66; 95% CI, 0.54-0.81), in non-diabetic (OR 0.66; 95% CI, 0.54-0.80) and in diabetic patients (OR 0.65; 95% CI, 0.49-0.87). This protective effect did not differ according to the participants' diabetic status nor follow-up length (test for subgroup differences I2=0). We found significant clinical and methodological heterogeneity. Similarly, the forest plot, and the I2 and Chi2 statistics suggested considerable statistical heterogeneity (I2=95%, p<0.05, respectively). Of the 12 included studies, 9 were at low risk of bias and 3 were at high risk of bias. Similarly, according to the funnel plot, it is very likely that there are important publication biases. CONCLUSION Statin use may significantly reduce the risk of tuberculosis in the general population, diabetic and non-diabetic patients. Nevertheless, caution should be exercised when interpreting these conclusions, due to the quality of the evidence, the heterogeneity of the studies, the presence of bias, and the difficulty in extrapolating these results to populations of other races and ethnicities.
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23
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Li G, Wang S, Xiong Y, Gu H, Yang K, Yang X, Wang C, Wang C, Li Z, Zhao X. Prior statin and short-term outcomes of primary intracerebral hemorrhage: From a large-scale nationwide longitudinal registry. CNS Neurosci Ther 2022; 28:1240-1248. [PMID: 35603937 PMCID: PMC9253784 DOI: 10.1111/cns.13868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 12/16/2022] Open
Abstract
Introduction The relationship between statins and intracerebral hemorrhage outcomes is unclear. Aim We aimed to compare the in‐hospital mortality and evacuation of intracranial hematoma rates in patients with primary intracerebral hemorrhage between prior statin users and nonusers. Results The final study population included 66,263 patients. Multivariable logistics analyses showed that prior statin use was not associated with in‐hospital mortality for primary intracerebral hemorrhage (adjusted odd ratio 0.78, 95% CI 0.61–1.01), but reduced the proportion of patients undergoing evacuation of intracranial hematoma (adjusted odd ratio 0.70, 95% CI 0.61–0.82). Propensity score matching analyses yielded similar results. Conclusion Prior statin use was not associated with in‐hospital mortality but did reduce evacuation of intracranial hematoma rates.
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Affiliation(s)
- Guangshuo Li
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shang Wang
- Neurocardiology Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yunyun Xiong
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Chinese Institute of Brain Research, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hongqiu Gu
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Kaixuan Yang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xin Yang
- China National Clinical Research Center for Neurological Diseases, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China
| | - Chunjuan Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China
| | - Chuanying Wang
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zixiao Li
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Chinese Institute of Brain Research, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.,Center for Stroke, Beijing Institute for Brain Disorders, Beijing, China
| | - Xingquan Zhao
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
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24
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Abstract
Primary hyperlipidemias include a heterogeneous set of monogenic and polygenic conditions characterized by a strong family aggregation, severe forms of hypercholesterolemia and/or hypertriglyceridemia, appearance early on life, and a high risk of cardiovascular events and/or recurrent pancreatitis. In real life, a small proportion of the primary hyperlipidemia cases is recognized and treated properly. Our goal is to present an update of current and upcoming therapies for patients with primary hyperlipidemia. Recently, new lipid-lowering medications have obtained authorization from the U.S. Food and Drug Administration and the European Medicines Agency. These drugs target metabolic pathways, including (adenosine 5'-triphosphates)-citrate lyase (bempedoic acid), proprotein convertase subtilisin/kexin 9 (inclisiran), apolipoprotein CIII (volanesorsen), and angiopoietin-like 3 (volanesorsen), that have additive effects with the actions of the currently available therapies (i.e., statins, ezetimibe or fibrates). We discuss the potential clinical indications for the novel medications. To conclude, the addition of these new medications to the therapeutic options for primary hyperlipidemia patients may increase the likelihood of achieving the treatment targets. Also, it could be a safer alternative for patients with side effects for the currently available drugs.
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Affiliation(s)
- Carlos A Aguilar-Salinas
- Direction of Nutrition Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, México
| | - Rita A Gómez-Díaz
- Unidad de Investigación Médica en Epidemiología Clínica, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Pablo Corral
- Pharmacology Department, School of Medicine, FASTA University, Mar del Plata, Buenos Aires, Argentina
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25
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Zuurbier SM, Hickman CR, Rinkel LA, Berg R, Sure U, Al-Shahi Salman R. Association Between Beta-Blocker or Statin Drug Use and the Risk of Hemorrhage From Cerebral Cavernous Malformations. Stroke 2022; 53:2521-2527. [PMID: 35410492 PMCID: PMC9311291 DOI: 10.1161/strokeaha.121.037009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We aimed to determine the association between beta-blocker or statin drug use and the future risk of symptomatic intracranial hemorrhage or persistent/progressive focal neurological deficit from cerebral cavernous malformations (CCM). METHODS The population-based Scottish Audit of Intracranial Vascular Malformations prospectively identified adults resident in Scotland first diagnosed with CCM during 1999 to 2003 or 2006 to 2010. We compared the association between beta-blocker or statin drug use after first presentation and the occurrence of new intracranial hemorrhage or persistent/progressive focal neurological deficit due to CCM for up to 15 years of prospective follow-up. We confirmed proportional hazards and used survival analysis with multivariable adjustment for age, intracranial hemorrhage at CCM presentation, and brain stem CCM location. RESULTS Sixty-three (21%) of 300 adults used beta-blockers (27/63 [43%] used propranolol), and 73 (24%) used statin drugs over 3634 person-years of follow-up. At baseline, the only statistically significant imbalances in prespecified potential confounders were age by statin use and intracranial hemorrhage at presentation by beta-blocker use. Beta-blocker use was associated with a lower risk of new intracranial hemorrhage or persistent/progressive focal neurological deficit (adjusted hazard ratio, 0.09 [95% CI, 0.01-0.66]; P=0.018). Statin use was associated with a nonsignificant lower risk of intracranial hemorrhage or persistent/progressive focal neurological deficit (adjusted hazard ratio, 0.37 [95% CI, 0.01-1.07]; P=0.067). CONCLUSIONS Beta-blocker, but not statin, use was associated with a lower risk of intracranial hemorrhage or persistent/progressive focal neurological deficit in patients with CCM.
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Affiliation(s)
- Susanna M Zuurbier
- Department of Neurology, Amsterdam University Medical Center, The Netherlands (S.M.Z., L.A.R.)
| | - Charlotte R Hickman
- Edinburgh Medical School, College of Medicine and Veterinary Medicine (C.R.H.)
| | - Leon A Rinkel
- Department of Neurology, Amsterdam University Medical Center, The Netherlands (S.M.Z., L.A.R.)
| | - Rebecca Berg
- University of Edinburgh, United Kingdom. Department of Neurosurgery, University of Duisburg-Essen, Germany (R.B., U.S.)
| | - Ulrich Sure
- University of Edinburgh, United Kingdom. Department of Neurosurgery, University of Duisburg-Essen, Germany (R.B., U.S.)
| | - Rustam Al-Shahi Salman
- Centre for Clinical Brain Sciences and Usher Institute of Population Health Sciences and Informatics (R.A.-S.S.)
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26
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Fallahzadeh MK, Ku E, Chu CD, McCulloch CE, Tuot DS. Racial Differences in Medication Utilization for Secondary Prevention of Cardiovascular Disease in Kidney Transplant Recipients: A Post Hoc Analysis of the FAVORIT Trial Cohort. Kidney Med 2022; 4:100438. [PMID: 35360084 PMCID: PMC8961224 DOI: 10.1016/j.xkme.2022.100438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Rationale & Objective Black kidney transplant recipients have higher prevalences of cardiovascular disease (CVD) risk factors and less intensive risk factor control than White kidney transplant recipients. Our objective was to evaluate racial disparities in receipt of statins and aspirin for secondary CVD prevention among kidney transplant recipients in the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) trial. Study Design Cohort study. Setting & Participants FAVORIT participants of White, Black, and Other races from the United States and Canada with a history of CVD at study entry or who experienced a nonfatal CVD event during follow-up. Predictor Race. Outcome Receipt of statins and aspirin for secondary CVD prevention. Analytical Approach We used parametric (Weibull), proportional-hazards, interval-censored survival models to evaluate the independent association of race with receipt of statins and aspirin for secondary CVD prevention. Results Of the 4,110 kidney transplant recipients enrolled in FAVORIT trial, 978 met the inclusion criteria (78% White, 17% Black, and 6% Other race). Compared with the White race, Black and Other races were associated with lower hazards of receiving statins (Black race: adjusted HR, 0.76 [95% CI, 0.60-0.97]; Other race: adjusted HR, 0.87 [95% CI, 0.60-1.27]) and aspirin (Black race: adjusted HR, 0.85 [95% CI, 0.67-1.08]; Other race: adjusted HR, 0.63 [95% CI, 0.43-0.94]). Limitations Lack of granular information on potential indications or contraindications for aspirin or statin use for secondary CVD prevention. Conclusions Post hoc findings from the FAVORIT trial demonstrated that Black race was associated with a lower likelihood of receiving statins and Other race was associated with a lower likelihood of receiving aspirin for secondary CVD prevention. This represents a potential target to improve CVD care in non-White kidney transplant recipients.
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Affiliation(s)
- Mohammad Kazem Fallahzadeh
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, CA
| | - Elaine Ku
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, CA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Chi D. Chu
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, CA
| | - Charles E. McCulloch
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Delphine S. Tuot
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, CA
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27
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Barrett R, Hodgkinson J. Impact of the COVID-19 pandemic on cardiovascular heart disease medication use: time-series analysis of England's prescription data during the COVID-19 pandemic (January 2019 to October 2020). Ther Adv Cardiovasc Dis 2022; 16:17539447221137170. [PMID: 36420815 PMCID: PMC9702971 DOI: 10.1177/17539447221137170] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 10/19/2022] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Management of high blood pressure (BP) typically requires adherence to medication regimes. However, it is known that the COVID-19 pandemic both interrupted access to some routine prescriptions and changed some patient health behaviours. AIM This study, therefore, retrospectively investigated prescription reimbursement of cardiovascular (CVD) medicines as a proxy measure for patient adherence and access to medicines during the pandemic. METHODS A cohort study of all primary care patients in England prescribed CVD medicines. The exposure was to the global pandemic. Prescriptions were compared before and after the pandemic's onset. Statistical variation was the outcome of interest. RESULTS Descriptive statistics show changes to monthly prescriptions, with wide confidence intervals indicating varying underlying practice. Analysis of variance reveals statistically significant differences for bendroflumethiazide, potassium-sparing diuretics, nicorandil, ezetimibe, ivabradine, ranolazine, colesevelam and midodrine. After the pandemic began (March-October 2020), negative parameters are observed for ACE inhibitors, beta-blockers, calcium channel blockers, statins, antiplatelet, antithrombotics, ARBs, loop diuretics, doxazosin, bendroflumethiazide, nitrates and indapamide, indicating decelerating monthly prescription items (statistically significant declines of calcium channel blockers, antithrombotic, adrenoreceptor blockers and diuretics) of CVD medicines within the general population. Many data points are not statistically significant, but fluctuations remain clinically important for the large population of patients taking these medications. CONCLUSION A concerning decline in uptake of CVD therapies for chronic heart disease was observed. Accessible screening and treatment alongside financial relief on prescription levies are needed. A video abstract is (4 min 51 s) available: https://bit.ly/39gvEHi.
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Affiliation(s)
- Ravina Barrett
- School of Applied Sciences, University of
Brighton, Cockcroft Building, Lewes Road, Moulsecoomb, Brighton BN2 4GJ,
UK
| | - James Hodgkinson
- Murray Learning Centre, Institute of Applied
Health Research, College of Medical and Dental Sciences, University of
Birmingham, Birmingham, UK
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28
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Al Harbi S, Kensara R, Aljuhani O, Korayem GB, Altebainawi AF, Al Harthi A, Vishwakarma R, Alenazi AM, Almutairi A, Alshaya O, Alraddadi S, Al Sulaiman T, Aldakkan L, Mahboob R, Alaamer K, Alissa A, Hafiz A, Aldhayyan N, Althewaibi S, Alenezi F, Alkhotani NY, Alghamdi SA, Alenazi AA, Al Sulaiman K. Statins and Risk of Thrombosis in Critically ill Patients with COVID-19: A Multicenter Cohort Study. Clin Appl Thromb Hemost 2022; 28:10760296221103864. [PMID: 35658686 PMCID: PMC9178978 DOI: 10.1177/10760296221103864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Coagulation abnormalities are one of the most important complications of severe COVID-19, which might lead to venous thromboembolism (VTE). Hypercoagulability with hyperfibrinogenemia causes large vessel thrombosis and major thromboembolic sequelae. Statins are potentially a potent adjuvant therapy in COVID-19 infection due to their pleiotropic effect. This study aims to evaluate the effectiveness of statins in reducing the risk of thrombosis among hospitalized critically ill patients with COVID-19. METHODS A multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were categorized based on their usage of statins throughout their ICU stay and were matched with a propensity score. The primary endpoint was the odds of all cases of thrombosis; other outcomes were considered secondary. RESULTS A total of 1039 patients were eligible; following propensity score matching, 396 patients were included (1:1 ratio). The odds of all thrombosis cases and VTE events did not differ significantly between the two groups (OR 0.84 (95% CI 0.43, 1.66), P = 0.62 and OR 1.13 (95% CI 0.43, 2.98), P = 0.81, respectively. On multivariable Cox proportional hazards regression analysis, patients who received statin therapy had lower 30-day (HR 0.72 (95 % CI 0.54, 0.97), P = 0.03) and in-hospital mortality (HR 0.67 (95 % CI 0.51, 0.89), P = 0.007). Other secondary outcomes were not statistically significant between the two groups except for D-dimer levels (peak) during ICU stay. CONCLUSION The use of statin therapy during ICU stay was not associated with thrombosis reduction in critically ill patients with COVID-19; however, it has been associated with survival benefits.
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Affiliation(s)
- Shmeylan Al Harbi
- Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia.,College of Pharmacy, 48149King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Raed Kensara
- Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia.,309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, 108781King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghazwa B Korayem
- Department of Pharmacy Practice, College of Pharmacy, 112893Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ali F Altebainawi
- Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia
| | - Abdullah Al Harthi
- Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia.,309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ramesh Vishwakarma
- Statistics Department, 81977European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - Alaa M Alenazi
- Pharmaceutical care department, 37849King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulmajed Almutairi
- Intensive Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Omar Alshaya
- Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia.,College of Pharmacy, 48149King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Sultan Alraddadi
- Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia.,College of Pharmacy, 48149King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Tareq Al Sulaiman
- Department of Orthopedic Surgery, 48179Imam Abdulrahman Al Faisal Hospital, Riyadh, Saudi Arabia
| | - Latifah Aldakkan
- Pharmaceutical Care Department, 48077Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Reem Mahboob
- Pharmaceutical care department, 327149King Abdulaziz Hospital, Jeddah, Saudi Arabia
| | - Kholoud Alaamer
- Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia.,College of Pharmacy, 48149King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Abdulrahman Alissa
- Pharmaceutical Care Department, 430300King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Awatif Hafiz
- Department of Pharmacy Practice, Faculty of Pharmacy, 108781King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nada Aldhayyan
- College of Pharmacy, 48149King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sara Althewaibi
- College of Pharmacy, 48149King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Farhan Alenezi
- 309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.,Intensive Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Nadeen Y Alkhotani
- Department of Pharmacy Practice, Faculty of Pharmacy, 108781King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sara A Alghamdi
- Department of Pharmacy Practice, Faculty of Pharmacy, 108781King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer A Alenazi
- Pharmaceutical Care Department, 37853Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khalid Al Sulaiman
- Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia.,College of Pharmacy, 48149King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.,Saudi Critical Care Pharmacy Research (SCAPE) Platform. Riyadh, Saudi Arabia
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29
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Vigneau AL, Rico C, Boerboom D, Paquet M. Statins downregulate YAP and TAZ and exert anti-cancer effects in canine mammary tumour cells. Vet Comp Oncol 2021; 20:437-448. [PMID: 34881506 DOI: 10.1111/vco.12789] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022]
Abstract
Canine mammary tumours (CMTs) are the most common neoplasms in intact bitches, and few chemotherapeutic options are available for highly invasive and metastatic tumours. Recent studies have shown the potential involvement of dysregulated Hippo signalling in CMT development and progression. Statins can activate the Hippo pathway by blocking protein geranylgeranylation (GGylation), resulting in decreased expression and activity of the transcriptional co-activators YAP and TAZ. In this study, we therefore sought to determine if statins could exert anti-cancer effects in CMT cells. Our results demonstrate that Atorvastatin and Fluvastatin are cytotoxic to two CMT cell lines (CMT9 and CMT47), with ED50 values ranging from 0.95 to 23.5 μM. Both statins acted to increase apoptosis and promote cell cycle arrest. Both statins also decreased YAP and TAZ expression and reduced the mRNA levels of key Hippo transcriptional target genes known to be involved in breast cancer progression and chemoresistance (CYR61, CTGF and RHAMM). Moreover, both statins effectively inhibited cell migration and anchorage independent growth, but did not influence matrix invasion. Taken together, our results demonstrate for the first time that statins act upon the Hippo pathway in CMT cells to counteract several molecular and cellular hallmarks of cancer. These findings suggest that targeting the Hippo pathway with statins represents a novel and promising approach for the treatment canine mammary gland cancers.
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Affiliation(s)
- Anne-Laurence Vigneau
- Département de Pathologie et de Microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - Charlène Rico
- Département de Biomédecine Vétérinaire, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - Derek Boerboom
- Département de Biomédecine Vétérinaire, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - Marilène Paquet
- Département de Pathologie et de Microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
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Kim SY, Yoo DM, Min C, Kim JH, Kwon MJ, Kim JH, Choi HG. Association between Osteoporosis and Previous Statin Use: A Nested Case-Control Study. Int J Environ Res Public Health 2021; 18:ijerph182211902. [PMID: 34831656 PMCID: PMC8620647 DOI: 10.3390/ijerph182211902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
The relationship between statin use and osteoporosis is controversial; therefore, this study aimed to investigate this association. The ≥40-year-old population of the Korean National Health Insurance Service Health Screening Cohort was enrolled. The 68,592 osteoporosis patients were matched 1:1 with control participants for age, sex, income, and region of residence using propensity score matching. The histories of statin use for two years before the diagnosis of osteoporosis (index date) in the osteoporosis and control groups were compared using conditional/unconditional logistic regression. An increased number of days of statin use was not associated with osteoporosis (adjusted OR (aOR) = 0.97, 95% confidence interval (95% CI) = 0.94–1.00, p = 0.052). In the subgroup analyses, a large number of days of statin use was related to a reduced rate of osteoporosis in the <60-year-old female group, while the opposite was true in the ≥60-year-old female group. Both lipophilic and hydrophilic statins were related to a decreased rate of osteoporosis in the <60-year-old female group. Lipophilic statins, but not hydrophilic statins, were associated with an increased rate of osteoporosis in the ≥60-year-old female group. Statin use showed different associations in middle-aged and elderly women.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea;
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea; (D.M.Y.); (C.M.)
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea; (D.M.Y.); (C.M.)
- Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Mi Jung Kwon
- Department of Pathology, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea; (D.M.Y.); (C.M.)
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence:
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31
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Ruff CT, Koren MJ, Grimsby J, Rosenbaum AI, Tu X, Karathanasis SK, Falloon J, Hsia J, Guan Y, Conway J, Tsai LF, Hummer BT, Hirshberg B, Kuder JF, Murphy SA, George RT, Sabatine MS. LEGACY: Phase 2a Trial to Evaluate the Safety, Pharmacokinetics, and Pharmacodynamic Effects of the Anti-EL (Endothelial Lipase) Antibody MEDI5884 in Patients With Stable Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2021; 41:3005-3014. [PMID: 34706556 DOI: 10.1161/atvbaha.120.315757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Functional HDL (high-density lipoprotein) particles that facilitate cholesterol efflux may be cardioprotective. EL (endothelial lipase) hydrolyzes phospholipids promoting catabolism of HDL and subsequent renal excretion. MEDI5884 is a selective, humanized, monoclonal, EL-neutralizing antibody. We sought to determine the safety, pharmacokinetics, and pharmacodynamic effects of multiple doses of MEDI5884 in patients with stable coronary artery disease. Approach and Results: LEGACY was a phase 2a, double-blind, placebo-controlled, parallel-design trial that randomized 132 patients with stable coronary artery disease receiving high-intensity statin therapy to 3 monthly doses of 1 of 5 dose levels of MEDI5884 (50, 100, 200, 350, or 500 mg SC) or matching placebo. The primary end point was the safety and tolerability of MEDI5884 through the end of the study (day 151). Additional end points included change in HDL cholesterol and cholesterol efflux from baseline to day 91, hepatic uptake of cholesterol at day 91, changes in various other lipid parameters. The incidence of adverse events was similar between the placebo and MEDI5884 groups. In a dose-dependent manner, MEDI5884 increased HDL cholesterol up to 51.4% (P<0.0001) and global cholesterol efflux up to 26.2% ([95% CI, 14.3-38.0] P<0.0001). MEDI5884 increased HDL particle number up to 14.4%. At the highest dose tested, an increase in LDL (low-density lipoprotein) cholesterol up to 28.7% (P<0.0001) and apoB (apolipoprotein B) up to 13.1% (P=0.04) was observed with MEDI5884. However, at the potential target doses for future studies, there was no meaningful increase in LDL cholesterol or apoB. CONCLUSIONS Inhibition of EL by MEDI5884 increases the quantity and quality of functional HDL in patients with stable coronary artery disease on high-intensity statin therapy without an adverse safety signal at the likely dose to be used. These data support further clinical investigation. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03351738.
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Affiliation(s)
- Christian T Ruff
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.T.R., J.F.K., S.A.M., M.S.S.)
| | | | - Joseph Grimsby
- Bioscience, Research and Early Development, Cardiovascular, Renal and Metabolism (J.G., S.K.K.), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD
| | - Anton I Rosenbaum
- Integrated Bioanalysis, Clinical Pharmacology and Quantitative Pharmacology (A.I.R., Y.G.), Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, South San Francisco, CA
| | - Xiao Tu
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and Metabolism (X.T., J.F., B.H., R.T.G.), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD
| | - Sotirios K Karathanasis
- Bioscience, Research and Early Development, Cardiovascular, Renal and Metabolism (J.G., S.K.K.), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD
| | - Judith Falloon
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and Metabolism (X.T., J.F., B.H., R.T.G.), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD
| | - Judith Hsia
- Research and Early Development, Cardiovascular, Renal and Metabolism (J.H.), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD
| | - Ye Guan
- Integrated Bioanalysis, Clinical Pharmacology and Quantitative Pharmacology (A.I.R., Y.G.), Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, South San Francisco, CA
| | - James Conway
- Bioinformatics, Translational Medicine, Research and Early Development, Oncology R&D, AstraZeneca, Gaithersburg, MD (J.C.)
| | - Lan-Feng Tsai
- Early CVRM Biometrics, Research and Early Development, Cardiovascular, Renal and Metabolism (L.-F.T.), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD
| | - B Timothy Hummer
- Cardiovascular, Renal and Metabolism Safety (B.T.H.), Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, South San Francisco, CA
| | - Boaz Hirshberg
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and Metabolism (X.T., J.F., B.H., R.T.G.), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD
| | - Julia F Kuder
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.T.R., J.F.K., S.A.M., M.S.S.)
| | - Sabina A Murphy
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.T.R., J.F.K., S.A.M., M.S.S.)
| | - Richard T George
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and Metabolism (X.T., J.F., B.H., R.T.G.), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD
| | - Marc S Sabatine
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (C.T.R., J.F.K., S.A.M., M.S.S.)
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32
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Brinton EA. Statin-Related New-Onset Diabetes Appears Driven by Increased Insulin Resistance: Are There Clinical Implications? Arterioscler Thromb Vasc Biol 2021; 41:2798-2801. [PMID: 34705475 DOI: 10.1161/atvbaha.121.316893] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Shin J, Kim H, Yim HW, Kim JH, Lee S, Kim HS. Angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers: New-onset diabetes mellitus stratified by statin use. J Clin Pharm Ther 2021; 47:97-103. [PMID: 34668200 DOI: 10.1111/jcpt.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/02/2021] [Accepted: 10/08/2021] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVES Regardless of statin use, which is known to induce hyperglycaemia, comparative studies on the risk of new-onset diabetes mellitus (NODM) with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are needed. This study evaluated the effects of ACEIs and ARBs on NODM in the clinical setting. METHODS This retrospective cohort study utilized electronic medical record data from Seoul St. Mary's Hospital and Seoul National University Hospital from 2009 to 2012. Patients who were prescribed ACEIs or ARBs for the first time (irrespective of concomitant statin use) were followed up for 5 years. RESULTS AND DISCUSSIONS A total of 11,703 patients were included, 24.9% (n = 2916) were taking ACEIs and 75.1% (n = 9189) were taking ARBs. Patients on ACEIs had a significantly lower incidence of NODM both with statin use (HR = 0.13, p < 0.001) and without (HR = 0.15, p = 0.009) than patients on ARBs. Age ≥60 years (HR = 1.49, p = 0.010), BMI ≥25 (HR = 1.96, p < 0.010), use of calcium channel blockers (HR = 1.47, p = 0.010), and diuretics (HR = 1.48, p = 0.010) were risk factors for NODM with statin use. WHAT IS NEW AND CONCLUSION Patients taking ACEIs are less likely to develop NODM than patients taking ARBs, irrespective of statin use. Patients' conditions, including the risk of NODM, should be considered before prescribing ACEIs or ARBs. Future randomized clinical trials are needed to clarify further the relationship between ACEIs and ARBs and their effect on NODM.
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Affiliation(s)
- Juyoung Shin
- Health Promotion Center, Seoul St. Mary's Hospital, Seoul, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyunah Kim
- College of Pharmacy, Sookmyung Women's University, Seoul, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ju Han Kim
- Division of Biomedical Informatics, Systems Biomedical Informatics Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Suehyun Lee
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Korea.,Health Care Data Science Center, Konyang University Hospital, Daejeon, Korea
| | - Hun-Sung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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34
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Bhagavathula AS, Vidyasaga K, Gebreyohannes EA, Tesfaye W. Risk of Gastrointestinal Bleeding on Treatment With Statin Alone or With Concomitant Administration of Warfarin: A Systematic Review and Meta-analysis of 5.3 Million Participants. Ann Pharmacother 2021; 56:820-830. [PMID: 34595940 DOI: 10.1177/10600280211049727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study aimed to comprehensively evaluate the risk of gastrointestinal bleeding (GIB) with statin monotherapy or with concomitant warfarin use. DATA SOURCES PubMed, Web of Science, and EMBASE (via Scopus) were searched for observational studies that reported the risk of GIB in adults on statin therapy or with concomitant warfarin use until August 28, 2021. STUDY SELECTION AND DATA EXTRACTION Observational studies evaluating the risk of GIB in adults (age >18 years) on statin medication or concomitant use with warfarin were included. DATA SYNTHESIS In all, 14 studies with a total of 5 235 123 participants, reporting 48 677 GIB events (43 734 from statin users and 4943 from users of statin combined with warfarin), were included in the analyses. The pooled analysis revealed no difference in the risk of GIB with statin monotherapy (relative risk [RR]: 0.65; 95% CI: 0.42-1.02) or concomitant statin + warfarin use (RR: 0.97; 95% CI: 0.91-1.02). Prior use of statin was not associated with GIB risk (RR: 0.88; 95% CI: 0.63-1.22), whereas a shorter duration of statin use (<5 years) was associated with a lower risk of GIB (RR: 0.42; 95% CI: 0.18-0.97). RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE This analysis provides strong evidence on the association between statin use (with/without warfarin) and risk of GIB. CONCLUSION Statin alone or combined with warfarin was not significantly associated with either an increased or decreased risk of GIB. The GIB risk was significantly lower when statins were used for a short duration (<5 years). The putative relationship between statins and GIB in warfarin users warrant further investigation.
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Affiliation(s)
| | | | | | - Wubshet Tesfaye
- University of Canberra, Australian Capital Territory, Australia
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35
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Kramer JJ, Gu L, Moreira D, Andriole G, Csizmadi I, Freedland SJ. Statin Use and Lower Urinary Tract Symptoms Incidence and Progression in Reduction by Dutasteride of Prostate Cancer Events (REDUCE) Trial. J Urol 2021;:101097JU0000000000002199. [PMID: 34544265 DOI: 10.1097/JU.0000000000002199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Benign prostatic hyperplasia (BPH) is a common disease often manifested by lower urinary tract symptoms (LUTS). We previously found statins were associated with modest attenuations in prostate growth over time in REDUCE. We tested whether statins were associated with LUTS incidence in asymptomatic men and LUTS progression in symptomatic men. MATERIALS AND METHODS We performed a post-hoc analysis of REDUCE in 3,060 "asymptomatic" men with baseline International Prostate Symptom Score (IPSS) <8 and in 2,198 symptomatic men with baseline IPSS ≥8 not taking α-blockers or 5α-reductase inhibitors. We used multivariable Cox regression models to assess associations between statin use at baseline and LUTS incidence and progression. Among asymptomatic men, incident LUTS was defined as the first reported medical or surgical treatment for BPH or sustained clinically significant LUTS (2 reports of IPSS >14). Among symptomatic men, LUTS progression was defined as IPSS increase ≥4 points from baseline, any surgical procedure for BPH, or initiation of a BPH drug. RESULTS Among asymptomatic and symptomatic men, 550 (18%) and 392 (18%) used statins at baseline, respectively. On multivariable analysis, statin use was not associated with LUTS incidence (HR 1.05; 95% CI 0.78-1.41, p=0.74) in asymptomatic men, or with LUTS progression (HR 1.13; 95% CI 0.96-1.33, p=0.15) in symptomatic men. Similar results were seen in the dutasteride and placebo arms when stratified by treatment assignment. CONCLUSIONS In REDUCE, statin use was not associated with either incident LUTS in asymptomatic men or LUTS progression in symptomatic men. These data do not support a role for statins in LUTS prevention or management.
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36
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Rimmer RA, Mace JC, Gill A, Alt J, Detwiller K, Geltzeiler M, Smith TL, Farrell NF. Association of statins with quality of life and olfaction in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol 2021; 12:237-239. [PMID: 34510817 DOI: 10.1002/alr.22880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 01/14/2023]
Affiliation(s)
- Ryan A Rimmer
- Department of Otolaryngology Head and Neck Surgery, Oregon Sinus Center, Oregon Health and Science University, Portland, OR
| | - Jess C Mace
- Department of Otolaryngology Head and Neck Surgery, Oregon Sinus Center, Oregon Health and Science University, Portland, OR
| | - Amarbir Gill
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT
| | - Jeremiah Alt
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT
| | - Kara Detwiller
- Department of Otolaryngology Head and Neck Surgery, Oregon Sinus Center, Oregon Health and Science University, Portland, OR
| | - Mathew Geltzeiler
- Department of Otolaryngology Head and Neck Surgery, Oregon Sinus Center, Oregon Health and Science University, Portland, OR
| | - Timothy L Smith
- Department of Otolaryngology Head and Neck Surgery, Oregon Sinus Center, Oregon Health and Science University, Portland, OR
| | - Nyssa Fox Farrell
- Department of Otolaryngology Head and Neck Surgery, Washington University in St. Louis, St. Louis, MO
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37
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Sanda K, Ayukawa Y, Yasunami N, Adachi N, Furuhashi A, Imai M, Matsunaka K, Koyano K. Therapeutic effect of fluvastatin on medication-related osteonecrosis of the jaw. J Periodontol 2021; 93:837-846. [PMID: 34510440 DOI: 10.1002/jper.21-0294] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/24/2021] [Accepted: 09/03/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Refractory jaw osteonecrosis that occurs in osteoporotic or cancer patients treated with bisphosphonates is called medication-related osteonecrosis of the jaw but its underlying mechanism is unclear. Statins, therapeutic agents for dyslipidemia, lower blood low-density lipoprotein cholesterol. Fluvastatin promotes the healing of tooth extraction sockets and reduces the risk of developing medication-related osteonecrosis of the jaw-like lesions. We used a rat model to investigate whether injecting fluvastatin at extraction sites promoted the healing of medication-related osteonecrosis of the jaw-like lesions. METHODS Upper first molars of rats administered zoledronate and dexamethasone for 2 weeks were extracted. Two weeks after tooth extraction, rats with medication-related osteonecrosis of the jaw-like lesions (bone exposure) were included in this study. A single injection of fluvastatin was administered in the vicinity of the medication-related osteonecrosis of the jaw-like onset site in rats. RESULTS The distance between the edges of the epithelia, the length of the necrotic bone exposed toward the oral cavity, the area of the necrotic bone, and the necrotic bone ratio were significantly smaller in the fluvastatin-administered group compared with the saline group. A single application of fluvastatin near the site of medication-related osteonecrosis of the jaw onset showed a tendency to close the epithelium, reduce necrotic bone, and form new bone, even when symptoms had already developed. CONCLUSION This study suggests that a single topical administration of fluvastatin may be a novel treatment for medication-related osteonecrosis of the jaw.
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Affiliation(s)
- Koma Sanda
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yasunori Ayukawa
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Noriyuki Yasunami
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Naomi Adachi
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Akihiro Furuhashi
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Mikio Imai
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Ken Matsunaka
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kiyoshi Koyano
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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38
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Affiliation(s)
- Janet Wei
- Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA (J.W., C.N.B.M.)
| | - James K Liao
- Section of Cardiology, University of Chicago, IL (J.K.L.)
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA (J.W., C.N.B.M.)
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39
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Kim SY, Yoo DM, Min C, Choi HG. Association between Statin Use and Meniere's Disease: Results from a National Health Screening Cohort. Int J Environ Res Public Health 2021; 18:8692. [PMID: 34444440 DOI: 10.3390/ijerph18168692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/11/2021] [Accepted: 08/15/2021] [Indexed: 12/27/2022]
Abstract
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.
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40
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Döbert M, Varouxaki AN, Mu AC, Syngelaki A, Ciobanu A, Akolekar R, De Paco Matallana C, Cicero S, Greco E, Singh M, Janga D, Del Mar Gil M, Jani JC, Bartha JL, Maclagan K, Wright D, Nicolaides KH. Pravastatin Versus Placebo in Pregnancies at High Risk of Term Preeclampsia. Circulation 2021; 144:670-679. [PMID: 34162218 DOI: 10.1161/circulationaha.121.053963] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Effective screening for term preeclampsia is provided by a combination of maternal factors with measurements of mean arterial pressure, serum placental growth factor, and serum soluble fms-like tyrosine kinase-1 at 35 to 37 weeks of gestation, with a detection rate of ≈75% at a screen-positive rate of 10%. However, there is no known intervention to reduce the incidence of the disease. METHODS In this multicenter, double-blind, placebo-controlled trial, we randomly assigned 1120 women with singleton pregnancies at high risk of term preeclampsia to receive pravastatin at a dose of 20 mg/d or placebo from 35 to 37 weeks of gestation until delivery or 41 weeks. The primary outcome was delivery with preeclampsia at any time after randomization. The analysis was performed according to intention to treat. RESULTS A total of 29 women withdrew consent during the trial. Preeclampsia occurred in 14.6% (80 of 548) of participants in the pravastatin group and in 13.6% (74 of 543) in the placebo group. Allowing for the effect of risk at the time of screening and participating center, the mixed-effects Cox regression showed no evidence of an effect of pravastatin (hazard ratio for statin/placebo, 1.08 [95% CI, 0.78-1.49]; P=0.65). There was no evidence of interaction between the effect of pravastatin, estimated risk of preeclampsia, pregnancy history, adherence, and aspirin treatment. There was no significant between-group difference in the incidence of any secondary outcomes, including gestational hypertension, stillbirth, abruption, delivery of small for gestational age neonates, neonatal death, or neonatal morbidity. There was no significant between-group difference in the treatment effects on serum placental growth factor and soluble fms-like tyrosine kinase-1 concentrations 1 and 3 weeks after randomization. Adherence was good, with reported intake of ≥80% of the required number of tablets in 89% of participants. There were no significant between-group differences in neonatal adverse outcomes or other adverse events. CONCLUSIONS Pravastatin in women at high risk of term preeclampsia did not reduce the incidence of delivery with preeclampsia. Registration: URL: https://www.isrctn.com; Unique identifier ISRCTN16123934.
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Affiliation(s)
- Moritz Döbert
- Fetal Medicine Research Institute, King's College Hospital, London, UK (M.D., A.N.V., A.C.M., A.S., A.C., K.H.N.)
| | - Anna Nektaria Varouxaki
- Fetal Medicine Research Institute, King's College Hospital, London, UK (M.D., A.N.V., A.C.M., A.S., A.C., K.H.N.)
| | - An Chi Mu
- Fetal Medicine Research Institute, King's College Hospital, London, UK (M.D., A.N.V., A.C.M., A.S., A.C., K.H.N.)
| | - Argyro Syngelaki
- Fetal Medicine Research Institute, King's College Hospital, London, UK (M.D., A.N.V., A.C.M., A.S., A.C., K.H.N.)
| | - Anca Ciobanu
- Fetal Medicine Research Institute, King's College Hospital, London, UK (M.D., A.N.V., A.C.M., A.S., A.C., K.H.N.)
| | | | - Catalina De Paco Matallana
- Hospital Clínico Universitario Virgen de la Arrixaca and Institute for Biomedical Research of Murcia, IMIB-Arrixaca, Spain (C.D.P.M.)
| | | | | | - Mandeep Singh
- Southend University Hospital, Westcliff-on-Sea, UK (M.S.)
| | - Deepa Janga
- North Middlesex University Hospital, London, UK (D.J.)
| | - Maria Del Mar Gil
- School of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain (M.d.M.G.).,Hospital Universitario de Torrejón, Madrid, Spain (M.d.M.G.)
| | - Jacques C Jani
- University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium (J.C.J.)
| | | | | | | | - Kypros H Nicolaides
- Fetal Medicine Research Institute, King's College Hospital, London, UK (M.D., A.N.V., A.C.M., A.S., A.C., K.H.N.)
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Machado-Duque ME, Garcia DA, Emura-Vélez MH, Gaviria-Mendoza A, Machado-Alba JE. Prevalence of the Use of Aspirin and Statins for Preventing Cardiovascular Events in the Colombian Population with Type 2 Diabetes Mellitus: Comparison of 2008 and 2018. J Prim Care Community Health 2021; 12:21501327211007015. [PMID: 33787394 PMCID: PMC8772352 DOI: 10.1177/21501327211007015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) greatly increases cardiovascular risk. Primary and secondary cardiovascular prevention lead to lower cardiovascular events, improved quality of life and lower costs related to complications. OBJECTIVE To estimate the proportion of patients with T2DM undergoing drug therapy for cardiovascular prevention (aspirin and statins) in Colombia and to describe the change in patterns of use between 2008 and 2018. METHODS This was a cross-sectional study comparing prescriptions for aspirin and statins in 2008 and in 2018 in outpatients diagnosed with T2DM. Records were obtained from a national drug claim database. The proportion of use of cardiovascular prevention drugs and antidiabetic drugs, medications for comorbidities and sociodemographic variables were analyzed for both periods. RESULTS In total, 26 742 patients in 2008 and 188 321 in 2018 with a diagnosis of T2DM treated with antidiabetic drugs were identified, among whom 57.5% and 44.2% received aspirin and 44.9% and 60.2% received statins, respectively. The use of high-intensity statins increased from 1.1% in 2008 to 95.2% in 2018. The probabilities of receiving drugs in 2008 and in 2018 were higher for men (OR: 1.12, 95% CI: 1.06-1.17 and OR: 1.26, 95% CI: 1.23-1.28, respectively), for those persons over 75 years of age (OR: 6.5, 95% CI: 5.3-7.9 and OR: 5.8, 95% CI: 5.4-6.2) and for those who also received clopidogrel (OR: 5.8, 95% CI: 4.4-7.6 and OR: 2.2, 95% CI: 2.1-2.4). CONCLUSIONS The use of high-intensity statins in patients with T2DM has increased significantly in the last decade, which should reduce cardiovascular events, morbidity and mortality.
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Affiliation(s)
- Manuel E Machado-Duque
- Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.,Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | | | | | - Andrés Gaviria-Mendoza
- Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.,Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
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42
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de Carvalho RDP, Côrrea Viana Casarin R, Lima POD, Cogo-Müller K. STATINSWITH POTENTIAL TO CONTROL PERIODONTITIS: FROM BIOLOGICAL MECHANISMS TO CLINICAL STUDIES. J Oral Biosci 2021; 63:232-244. [PMID: 34146687 DOI: 10.1016/j.job.2021.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Statins are widely used for the treatment of hyperlipidemia. However, these drugs have pleiotropic effects that can be promising for the prevention and treatment of oral diseases, such as periodontitis. HIGHLIGHT This review aimed to identify preclinical, observational, and clinical studies that evaluate the effects and biological mechanisms of statins on oral cells and tissues and those using these drugs to treat periodontitis. A LITERATURE SURVEY HAS BEEN CONDUCTED IN PUBMED USING COMBINATIONS OF THE UNITERMS: "statins," "dentistry," "periodontal disease," and "periodontal treatment." In vitro findings showed positive statin results in cell lines related to alveolar bone metabolism by altering the signaling pathway Osteoprotegerin/Receptor Activator of Nuclear Factor Kappa B/Receptor Activator of Nuclear Factor Kappa B Ligand (OPG/RANK/RANKL), stimulating the production of alkaline phosphatase and osteocalcin, and reducing the production of matrix metalloproteinases (MMPs). Animal studies have shown a reduction in alveolar bone loss and osteoclastic activity, in addition to a reduction in inflammatory markers, such as IL-1, IL-6, and TNF-α, when statins were used prophylactically. Clinical trials showed a positive impact on clinical parameters, leading to a higher reduction in probing depth and gain in clinical attachment when a local statin was adjunctively associated with mechanical therapy. CONCLUSION Statins were shown to be promising for regenerating and stimulating bone activity, with great potential for treating chronic periodontitis. However, further studies are required to confirm its effectiveness.
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Affiliation(s)
| | | | | | - Karina Cogo-Müller
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, SP, Brazil
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43
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Dearborn-Tomazos JL, Hu X, Bravata DM, Phadke MA, Baye FM, Myers LJ, Concato J, Zillich AJ, Reeves MJ, Sico JJ. Deintensification or No Statin Treatment Is Associated With Higher Mortality in Patients With Ischemic Stroke or Transient Ischemic Attack. Stroke 2021; 52:2521-2529. [PMID: 34015937 DOI: 10.1161/strokeaha.120.030089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Jennifer L Dearborn-Tomazos
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (J.L.D.-T.)
| | - Xin Hu
- Yale Center for Analytical Sciences, New Haven, CT (X.H., M.A.P.)
| | - Dawn M Bravata
- Department of Veterans Affairs Health Services Research and Development Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN (D.M.B., F.M.B., L.J.M.).,Indiana University School of Medicine, Indianapolis (D.M.B., F.M.B., L.J.M.).,Regenstrief Institute, Indianapolis, IN (D.M.B.)
| | - Manali A Phadke
- Yale Center for Analytical Sciences, New Haven, CT (X.H., M.A.P.)
| | - Fitsum M Baye
- Department of Veterans Affairs Health Services Research and Development Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN (D.M.B., F.M.B., L.J.M.).,Indiana University School of Medicine, Indianapolis (D.M.B., F.M.B., L.J.M.)
| | - Laura J Myers
- Department of Veterans Affairs Health Services Research and Development Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN (D.M.B., F.M.B., L.J.M.).,Indiana University School of Medicine, Indianapolis (D.M.B., F.M.B., L.J.M.)
| | - John Concato
- Department of Medicine (J.C.), Yale University School of Medicine, New Haven, CT.,Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD (J.C.)
| | - Alan J Zillich
- Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, IN (A.J.Z.)
| | - Mathew J Reeves
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing (M.J.R.)
| | - Jason J Sico
- Department of Neurology and Department of Internal Medicine (J.J.S.), Yale University School of Medicine, New Haven, CT.,VA Connecticut Healthcare System, West Haven (J.J.S.)
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44
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Borne E, Meyer N, Blanchard O, Lombard M, Vogel T, Lang PO, Michel B. Statin (mis)use in older people: A cross-sectional study using French health insurance databases. Pharmacoepidemiol Drug Saf 2021; 30:1084-1090. [PMID: 33949722 DOI: 10.1002/pds.5262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/28/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE To describe the occurrence of potential statin misuse, its characteristics and associated factors in older people. METHODS A retrospective cross-sectional study was conducted in Alsace and Lorraine (France) using French health insurance databases. Study population comprised community-dwelling patients and nursing homes residents aged 80 and over, who received at least one statin prescription between January 1, 2017 to April 30, 2017 (N = 38 268). Potential statin misuse was identified considering off-label uses, high-intensity doses, drug contraindications and statin-drug interactions. RESULTS At least one potential statin misuse was detected for 19 468 patients (50.9%). Off-label prescription was the most frequent misuse observed (53.6%), followed by high-intensity statin dose (30.5%). Polypharmacy (five to nine drugs) and excessive polypharmacy (10 or more drugs) were the main risk factors associated with potential statin misuse (adjusted OR = 2.6 and 4.7 respectively). Nursing home, multi-morbidity and the presence of multiple prescriptions from different doctors for the same patient were other risk factors significantly associated. Two sensitivity analyzes (reconsiderations of off-label and high statin dose definitions) revealed the same statistical trend. CONCLUSION Potential statin misuse is frequent in people aged 80 and over. These findings should serve as a warning to health care professionals and hopefully will contribute to ensure an appropriate and safe use of statin in aged population.
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Affiliation(s)
- Emilie Borne
- OMEDIT Grand Est, Regional Health Agency, Strasbourg, France
| | - Nicolas Meyer
- Department of Public Health, University Hospitals of Strasbourg, Strasbourg, France.,Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Odile Blanchard
- Regional Direction of Medical Service, CNAM, Strasbourg, France
| | - Martial Lombard
- Regional Direction of Medical Service, CNAM, Strasbourg, France
| | - Thomas Vogel
- Faculty of Medicine, University of Strasbourg, Strasbourg, France.,Department of Geriatrics, University Hospitals of Strasbourg, Strasbourg, France
| | | | - Bruno Michel
- OMEDIT Grand Est, Regional Health Agency, Strasbourg, France.,Department of Pharmacy, University Hospitals of Strasbourg, Strasbourg, France.,Faculty of Pharmacy, UR 7296 Laboratory of Neuro-cardiovascular Pharmacology and Toxicology, University of Strasbourg, Strasbourg, France
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45
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Zupanic E, Kramberger MG, von Euler M, Norrving B, Winblad B, Secnik J, Fastbom J, Eriksdotter M, Garcia-Ptacek S. Secondary Stroke Prevention After Ischemic Stroke in Patients with Alzheimer's Disease and Other Dementia Disorders. J Alzheimers Dis 2021; 73:1013-1021. [PMID: 31884483 PMCID: PMC7081091 DOI: 10.3233/jad-191011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Recurrent ischemic stroke (IS) increases the risk of cognitive decline. To lower the risk of recurrent IS, secondary prevention is essential. Objective: Our aim was to compare post-discharge secondary IS prevention and its maintenance up to 3 years after first IS in patients with and without Alzheimer’s disease and other dementia disorders. Methods: Prospective open-cohort study 2007–2014 from the Swedish national dementia registry (SveDem) and the Swedish national stroke registry (Riksstroke). Patients with dementia who experienced an IS (n = 1410; 332 [23.5%] with Alzheimer’s disease) were compared with matched non-dementia IS patients (n = 7150). We analyzed antiplatelet, anticoagulant, blood pressure lowering, and statin treatment as planned medication initiation at discharge and actual dispensation of medications at first, second, and third year post-stroke. Results: At discharge, planned initiation of medication was higher in patients with dementia compared to non-dementia patients for antiplatelets (OR with 95% CI for fully adjusted models 1.23 [1.02–1.48]) and lower for blood pressure lowering medication (BPLM; 0.57 [0.49–0.67]), statins (0.57 [0.50–0.66]), and anticoagulants (in patients with atrial fibrillation – AF; 0.41 [0.32–0.53]). When analysis for antiplatelets was stratified according to the presence of AF, ORs for receiving antiplatelets remained significant only in the presence of AF (in the presence of AF 1.56 [1.21–2.01], in patients without AF 0.99 [0.75–1.33]). Similar trends were observed in 1st, 2nd, and 3rd year post-stroke. Conclusions: Dementia was a predictor of lower statin and BPLM use. Patients with dementia and AF were more likely to be prescribed antiplatelets and less likely to receive anticoagulants.
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Affiliation(s)
- Eva Zupanic
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Neurogeriatrics, Solna, Sweden.,Department of Neurology, University Medical Centre, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Milica G Kramberger
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Neurogeriatrics, Solna, Sweden.,Department of Neurology, University Medical Centre, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Mia von Euler
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset and Department of Medicine, Solna, Stockholm, Sweden.,Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
| | - Bo Norrving
- Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Neurology, Lund, Sweden
| | - Bengt Winblad
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Neurogeriatrics, Solna, Sweden.,Karolinska University Hospital, Theme Aging, Stockholm, Sweden
| | - Juraj Secnik
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Huddinge, Sweden
| | - Johan Fastbom
- Karolinska Institutet and Stockholm University, Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Stockholm, Sweden
| | - Maria Eriksdotter
- Karolinska University Hospital, Theme Aging, Stockholm, Sweden.,Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Huddinge, Sweden
| | - Sara Garcia-Ptacek
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Huddinge, Sweden.,Department of Internal Medicine Section for Neurology, Södersjukhuset, Stockholm, Sweden
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46
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Affiliation(s)
- Thomas Eschenhagen
- Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg Eppendorf, Germany (T.E.).,German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany (T.E.)
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Cárdenas-Jaén K, Archibugi L, Poropat G, Korpela T, Maisonneuve P, Aparicio JR, Udd M, Stimac D, Arcidiacono PG, De Pretis N, Valente R, Di Giulio E, Casellas JA, Kylänpää L, Hauser G, Mariani A, Gabbrielli A, Löhr M, Vanella G, Rainio M, Brozzi L, Arnelo U, Fagerström N, Capurso G, de-Madaria E. Chronic use of statins and acetylsalicylic acid and incidence of post-endoscopic retrograde cholangiopancreatography acute pancreatitis: A multicenter, prospective, cohort study. Dig Endosc 2021; 33:639-647. [PMID: 32713065 DOI: 10.1111/den.13801] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/20/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis (PEP) is a frequent complication of this endoscopic procedure. Chronic statin intake has been linked to lower incidence and severity of acute pancreatitis (AP). Periprocedural rectal administration of non-steroidal anti-inflammatory drugs is protective against PEP, but the role of chronic acetylsalicylic acid (ASA) treatment is unclear. We aimed to investigate whether statins and chronic ASA intake are associated with lower risk of PEP. METHODS An international, multicenter, prospective cohort study. Consecutive patients undergoing ERCP in seven European centers were included. Patients were followed-up to detect those with PEP. Multivariate analysis by means of binary logistic regression was performed, and adjusted odds ratios (aORs) were calculated. RESULTS A total of 1150 patients were included, and 70 (6.1%) patients developed PEP. Among statins users, 8.1% developed PEP vs. 5.4% among non-users (P = 0.09). Multivariate analysis showed no association between statin use and PEP incidence (aOR 1.68 (95% CI 0.94-2.99, P = 0.08)). Statin use had no effect on severity of PEP, being mild in 92.0% of statin users vs. 82.2% in non-statin users (P = 0.31). Chronic ASA use was not associated with PEP either (aOR 1.02 (95% CI 0.49-2.13), P = 0.96). Abuse of alcohol and previous endoscopic biliary sphincterotomy were protective factors against PEP, while >1 pancreatic guidewire passage, normal bilirubin values, and duration of the procedure >20 minutes, were risk factors. CONCLUSIONS The use of statins or ASA is not associated with a lower risk or a milder course of PEP.
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Affiliation(s)
- Karina Cárdenas-Jaén
- Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Livia Archibugi
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy
| | - Goran Poropat
- Department of Gastroenterology, Faculty of Medicine, Clinical Hospital Center of Rijeka, University of Rijeka, Rijeka, Croatia
| | - Taija Korpela
- Gastroenterological Surgery, Abdominal Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Jose R Aparicio
- Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Marianne Udd
- Gastroenterological Surgery, Abdominal Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Davor Stimac
- Department of Gastroenterology, Faculty of Medicine, Clinical Hospital Center of Rijeka, University of Rijeka, Rijeka, Croatia
| | - Paolo G Arcidiacono
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy
| | - Niccolò De Pretis
- Gastroenterology Unit, Department of Medicine, Pancreas Center, University of Verona, Verona, Italy
| | - Roberto Valente
- Gastrocentrum, Karolinska University Hospital, Stockholm, Sweden
| | - Emilio Di Giulio
- Digestive and Liver Disease Unit, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Juan A Casellas
- Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Leena Kylänpää
- Gastroenterological Surgery, Abdominal Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Goran Hauser
- Department of Gastroenterology, Faculty of Medicine, Clinical Hospital Center of Rijeka, University of Rijeka, Rijeka, Croatia
| | - Alberto Mariani
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy
| | - Armando Gabbrielli
- Gastroenterology Unit, Department of Medicine, Pancreas Center, University of Verona, Verona, Italy
| | - Matthias Löhr
- Gastrocentrum, Karolinska University Hospital, Stockholm, Sweden
| | - Giuseppe Vanella
- Digestive and Liver Disease Unit, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Mia Rainio
- Gastroenterological Surgery, Abdominal Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Lorenzo Brozzi
- Gastroenterology Unit, Department of Medicine, Pancreas Center, University of Verona, Verona, Italy
| | - Urban Arnelo
- Gastrocentrum, Karolinska University Hospital, Stockholm, Sweden
| | | | - Gabriele Capurso
- Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele University, Milan, Italy.,Digestive and Liver Disease Unit, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Enrique de-Madaria
- Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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Valladales-Restrepo LF, Medina-Morales DA, Giraldo-Giraldo C, Machado-Alba JE. Prescription of statins and pharmacokinetic interactions in Colombian patients. Expert Opin Drug Metab Toxicol 2021; 17:627-634. [PMID: 33759676 DOI: 10.1080/17425255.2021.1908261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Statins have extensive hepatic metabolism and can have multiple pharmacological interactions. The aim was to identify the main pharmacokinetic interactions between statins and their comedications in a group of patients from Colombia.Research design and methods: A cross-sectional study of pharmacokinetic interactions in patients treated with statins who were identified from a population database. The interactions were documented using the Lexicomp® database.Results: A total of 123,026 patients with statin prescriptions were identified, with a mean age of 68.4 ± 11.5 years; 57.1% were women, and 81.6% received atorvastatin. A total of 19.4% (n = 23.831) of patients presented pharmacological interactions. Some 15,474 (12.6%) had interactions classified as category C, 7.4% (n = 9077) as category D, and 0.5% (n = 660) as category X. 36.8% of the patients with lovastatin prescriptions had some interaction. Age older than 65 years, male sex, residence in capital cities, comorbidities, endocrine pathologies and HIV were associated with an increase in the probability of having contraindicated or risky interactions.Conclusions: Important interactions between statins and other medications were more common in adults over 65 years of age and those with endocrine comorbidities or HIV infection. This knowledge should help when proposing solutions that reduce the risk of adverse reactions.
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Affiliation(s)
- Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia.,Grupo De Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Diego Alejandro Medina-Morales
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia.,Grupo De Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Claudia Giraldo-Giraldo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia
| | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Pereira, Risaralda, Colombia
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Zhu L, Liu F, Hao Q, Feng T, Chen Z, Luo S, Xiao R, Sun M, Zhang T, Fan X, Zeng X, He J, Yuan P, Liu J, Ruiz M, Dupuis J, Hu Q. Dietary Geranylgeranyl Pyrophosphate Counteracts the Benefits of Statin Therapy in Experimental Pulmonary Hypertension. Circulation 2021; 143:1775-1792. [PMID: 33660517 DOI: 10.1161/circulationaha.120.046542] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The mevalonate pathway generates endogenous cholesterol and intermediates including geranylgeranyl pyrophosphate (GGPP). By reducing GGPP production, statins exert pleiotropic or cholesterol-independent effects. The potential regulation of GGPP homeostasis through dietary intake and the interaction with concomitant statin therapy is unknown. METHODS We developed a sensitive high-pressure liquid chromatography technique to quantify dietary GGPP and conducted proteomics, qualitative real-time polymerase chain reaction screening, and Western blot to determine signaling cascades, gene expression, protein-protein interaction, and protein membrane trafficking in wild-type and transgenic rats. RESULTS GGPP contents were highly variable depending on food source that differentially regulated blood GGPP levels in rats. Diets containing intermediate and high GGPP reduced or abolished the effects of statins in rats with hypoxia- and monocrotaline-induced pulmonary hypertension: this was rescuable by methyl-allylthiosulfinate and methyl-allylthiosulfinate-rich garlic extracts. In human pulmonary artery smooth muscle cells treated with statins, hypoxia activated RhoA in an extracellular GGPP-dependent manner. Hypoxia-induced ROCK2 (Rho associated coiled-coil containing protein kinase 2)/Rab10 (Ras-related protein rab-10) signaling was prevented by statin and recovered by exogenous GGPP. The hypoxia-activated RhoA/ROCK2 pathway in rat and human pulmonary artery smooth muscle cells upregulated the expression of Ca2+-sensing receptor (CaSR) and HIMF (hypoxia-induced mitogenic factor), a mechanism attenuated by statin treatment and regained with exogenous GGPP. Rab10 knockdown almost abrogated hypoxia-promoted CaSR membrane trafficking, a process diminished by statin and resumed by exogenous GGPP. Hypoxia-induced pulmonary hypertension was reduced in rats with CaSR mutated at the binding motif of HIMF and the interaction between dietary GGPP and statin efficiency was abolished. In humans fed a high GGPP diet, blood GGPP levels were increased. This abolished statin-lowering effects on plasma GGPP, and also on hypoxia-enhanced RhoA activity of blood monocytes that was rescued by garlic extracts. CONCLUSIONS There is important dietary regulation of GGPP levels that interferes with the effects of statin therapy in experimental pulmonary hypertension. These observations rely on a key and central role of RhoA-ROCK2 cascade activation and Rab10-faciliated CaSR membrane trafficking with subsequent overexpression and binding of HIMF to CaSR. These findings warrant clinical investigation for the treatment of pulmonary hypertension and perhaps other diseases by combining statin with garlic-derived methyl-allylthiosulfinate or garlic extracts and thus circumventing dietary GGPP variations.
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Affiliation(s)
- Liping Zhu
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fangbo Liu
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiang Hao
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tian Feng
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zeshuai Chen
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shengquan Luo
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Xiao
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengxiang Sun
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Zhang
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohang Fan
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xianqin Zeng
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianguo He
- State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.H.)
| | - Ping Yuan
- Department of Cardiopulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China (P.Y., J.L.)
| | - Jinming Liu
- Department of Cardiopulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China (P.Y., J.L.)
| | - Matthieu Ruiz
- Departments of Nutrition (M.R.), Université de Montréal, Canada.,Montreal Heart Institute Research Center, Canada (M.R., J.D.)
| | - Jocelyn Dupuis
- Medicine (J.D.), Université de Montréal, Canada.,Montreal Heart Institute Research Center, Canada (M.R., J.D.)
| | - Qinghua Hu
- Department of Pathophysiology, School of Basic Medicine (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Pulmonary Diseases of Ministry of Health (L.Z., F.L., Q. Hao, T.F., Z.C., S.L., R.X., M.S., T.Z., X.F., X.Z., Q. Hu), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Oh TK, Song IA, Jeon YT. Statin Therapy and the Risk of COVID-19: A Cohort Study of the National Health Insurance Service in South Korea. J Pers Med 2021; 11:jpm11020116. [PMID: 33578937 PMCID: PMC7916713 DOI: 10.3390/jpm11020116] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 12/21/2022] Open
Abstract
We aimed to investigate whether statin therapy is associated with the incidence of coronavirus disease 2019 (COVID-19) among the South Korean population. In addition, we examined whether statin therapy affects hospital mortality among COVID-19 patients. The National Health Insurance Service (NHIS)-COVID-19 database in South Korea was used for data extraction for this population-based cohort study. A total of 122,040 adult individuals, with 22,633 (18.5%) in the statin therapy group and 101,697 (91.5%) in the control group, were included in the analysis. Among them, 7780 (6.4%) individuals were diagnosed with COVID-19 and hospital mortality occurred in 251 (3.2%) COVID-19 cases. After propensity score matching, logistic regression analysis showed that the odds of developing COVID-19 were 35% lower in the statin therapy group than in the control group (odds ratio: 0.65, 95% confidence interval: 0.60 to 0.71; p < 0.001). Regarding hospital mortality among COVID-19 patients, the multivariable model indicated that there were no differences between the statin therapy and control groups (odds ratio: 0.74, 95% confidence interval: 0.52 to 1.05; p = 0.094). Statin therapy may have potential benefits for the prevention of COVID-19 in South Korea. However, we found that statin therapy does not affect the hospital mortality of patients who are diagnosed with COVID-19.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Korea; (T.K.O.); (I.-A.S.)
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Korea; (T.K.O.); (I.-A.S.)
| | - Young-Tae Jeon
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Korea; (T.K.O.); (I.-A.S.)
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea
- Correspondence:
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