| アブストラクト | OBJECTIVE: To assess the effect of statin use on the risk of cardiovascular disease (CVD), all-cause mortality, and type 2 diabetes mellitus (DM) in patients with rheumatoid arthritis (RA). METHODS: We identified a cohort of patients with RA between 1989 and 2018, within the UK Clinical Practice Research Datalink. We employed a prevalent new-user cohort design by which patients initiating statins were each matched to 2 concurrent nonusers by the time-conditional propensity score (TCPS). Patients were followed until the occurrence of the composite end point of myocardial infarction, stroke, hospitalized heart failure or CVD mortality, all-cause mortality, and incident type 2 DM. The Cox proportional hazards model was used to estimate the hazard ratio (HR) of each outcome associated with as-treated statin use, with adjustment for TCPS deciles and imbalanced covariables. RESULTS: Among 1,768 statin initiators and 3,528 nonusers, 63 versus 340 CVD (3.0 per 100 person-years versus 2.7 per 100 person-years) and 62 versus 525 deaths (2.8 per 100 person-years versus 4.1 per 100 person-years) occurred. Incident type 2 DM was noted in 128 of 3,608 statin initiators (3.0 per 100 person-years) and 518 of 7,208 nonusers (2.0 per 100 person-years). Statin initiation was associated with 32% (HR 0.68 [95% confidence interval (95% CI) 0.51-0.90]) reduction in CVD, 54% (HR 0.46 [95% CI 0.35-0.60]) reduction in all-cause mortality, and 33% increase in type 2 DM (HR 1.33 [95% CI 1.09-1.63]). The number needed to treat/number needed to harm to prevent a CVD or all-cause mortality or to cause type 2 DM in 1 year was 102, 42, and 127, respectively. CONCLUSION: Statins are associated with important reductions in CVD and mortality that outweigh the modest increase in type 2 DM risk in RA patients. |
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| ジャーナル名 | Arthritis care & research |
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| Pubmed追加日 | 2022/2/5 |
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| 投稿者 | Ozen, Gulsen; Dell'Aniello, Sophie; Pedro, Sofia; Michaud, Kaleb; Suissa, Samy |
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| 組織名 | University of Nebraska Medical Center, Omaha.;Jewish General Hospital, Montreal, Quebec, Canada.;FORWARD, The National Databank for Rheumatic Diseases, Wichita, Kansas.;University of Nebraska Medical Center, Omaha, and FORWARD, The National Databank;for Rheumatic Diseases, Wichita, Kansas.;Jewish General Hospital and McGill University, Montreal, Quebec, Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35119769/ |
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