Journal article
Reduction of Cardiovascular Disease and Mortality Versus Risk of New-Onset Diabetes Mellitus With Statin Use in Patients With Rheumatoid Arthritis
Arthritis care & research (2010), Vol.75(3), pp.597-607
03/2023
DOI: 10.1002/acr.24866
PMID: 35119769
Abstract
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).
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.
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.
Statins are associated with important reductions in CVD and mortality that outweigh the modest increase in type 2 DM risk in RA patients.
Details
- Title: Subtitle
- Reduction of Cardiovascular Disease and Mortality Versus Risk of New-Onset Diabetes Mellitus With Statin Use in Patients With Rheumatoid Arthritis
- Creators
- Gulsen Ozen - University of Nebraska Medical CenterSophie Dell'Aniello - Jewish General HospitalSofia Pedro - The National Databank for Rheumatic DiseasesKaleb Michaud - The National Databank for Rheumatic DiseasesSamy Suissa - McGill University
- Resource Type
- Journal article
- Publication Details
- Arthritis care & research (2010), Vol.75(3), pp.597-607
- DOI
- 10.1002/acr.24866
- PMID
- 35119769
- ISSN
- 2151-464X
- eISSN
- 2151-4658
- Language
- English
- Date published
- 03/2023
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984702941002771
Metrics
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