Adherence with statins and all-cause mortality in days with high temperature.

IF 2.4 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Gabriel Chodick, Ran S Rotem, Todd A Miano, Warren B Bilker, Sean Hennessy
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Abstract

Purpose: It has been suggested that statins may exert thermo-protective effects that can reduce mortality on hot days. We aimed to examine the relationship between statin adherence and mortality in days with high temperature.

Methods: Utilizing data from a prior historical new-user cohort study, we analyzed a cohort of 229 918 individuals within a state-mandated health provider in Israel who initiated statin therapy between 1998 and 2006. Adherence to statins was assessed through the mean proportion of days covered (PDC) with statins during the follow-up period. The study's primary outcome was all-cause mortality during hot days.

Results: During the study follow-up period, a total of 13 165 individuals (5.7%) died. In a multivariable model, a 10% increase in PDC with statins was associated with an HR of (0.85; 95% CI: 0.72-1.00) for deaths (n = 16) in extremely hot days (≥39°C). This association was numerically stronger compared to HR = 0.94 (0.93-0.94) in cooler days and displayed a significant difference between sexes. In males, the fully-adjusted HR for a 10% increase in PDC with statins was 0.66 (0.45-0.95), while in women, it was 0.98 (0.78-1.23). In contrast, no such effect modification was observed for death in cooler days.

Conclusions: These findings align with earlier research, supporting the notion that adherence with statin treatment may be associated with a reduced risk of death during extremely hot days, particularly among men.

高温天他汀类药物的依从性和全因死亡率。
目的:有研究表明,他汀类药物可发挥热保护作用,从而降低高温天的死亡率。我们旨在研究他汀类药物的依从性与高温天死亡率之间的关系:我们利用之前一项历史性新用户队列研究的数据,分析了以色列国家规定的医疗机构中 229 918 名在 1998 年至 2006 年期间开始他汀类药物治疗的人的队列。他汀类药物的依从性通过随访期间他汀类药物的平均覆盖天数比例(PDC)进行评估。研究的主要结果是高温天的全因死亡率:在研究随访期间,共有 13 165 人(5.7%)死亡。在多变量模型中,他汀类药物的 PDC 值每增加 10%,极热天(≥39°C)的死亡 HR 值(0.85;95% CI:0.72-1.00)为(n = 16)。与较凉爽天的 HR = 0.94(0.93-0.94)相比,这种关联在数值上更强,并且在性别上有显著差异。在男性中,使用他汀类药物后 PDC 增加 10% 的完全调整 HR 为 0.66(0.45-0.95),而在女性中则为 0.98(0.78-1.23)。相比之下,在凉爽天死亡的情况下没有观察到这种效应的改变:这些研究结果与之前的研究结果一致,支持坚持他汀类药物治疗可降低酷热天死亡风险的观点,尤其是在男性中。
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来源期刊
CiteScore
4.80
自引率
7.70%
发文量
173
审稿时长
3 months
期刊介绍: The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.
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