他汀类药物用于动脉粥样硬化性血管疾病妇女的二级预防：全国范围内对24,665名因冠状动脉、脑血管或外周动脉疾病住院的妇女的分析

IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention Pub Date : 2025-04-25 DOI:10.1016/j.ijcrp.2025.200415

Gregor Verček , Tjaša Furlan , Dalibor Gavrić , Mitja Lainščak , Jerneja Farkaš Lainščak , Irena Ograjenšek , Petra Došenović Bonča , Borut Jug

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引用次数: 0

摘要

背景：基于随机试验，他汀类药物被推荐用于动脉粥样硬化性血管疾病（ASCVD）的二级预防，这些试验主要招募了患有冠状动脉疾病（CAD）的男性，而女性和患有脑血管疾病（CVD）和外周动脉疾病（PAD）的患者代表性不足。我们分析了他汀类药物在全国范围内因ASCVD住院的女性队列中的有效性。方法通过连接国家医院数据库、药品报销申请和国家死亡率登记处，回顾性分析2015年至2021年间因CAD、CVD或PAD（包括主动脉疾病）住院的女性。出院后30天内他汀类药物摄入与临床结果（全因死亡率和心血管住院）的关系通过Kaplan-Meier曲线和Cox比例风险回归模型进行评估，该模型采用倾向评分衍生的治疗权重逆概率和30天里程碑期。结果：我们纳入了24665名ASCVD患者，其中CAD患者14419人，CVD患者5427人，PAD患者4819人。总体而言，中位年龄为73岁（64-81岁）。他汀类药物的摄取率在CAD患者中为50%，CVD患者为60%，PAD患者为28%。他汀类药物治疗与三种主要类型ASCVD的全因死亡率和心血管住院率降低相关：CAD的风险比（HR） 0.88, 95%可信区间（CI） 0.83-0.93, p = 0.001， PAD的风险比（HR） 0.87, 95% CI 0.80-0.94, p = 0.006, HR 0.72, 95% CI 0.66-0.78, p <；CVD为0.001。结论他汀类药物治疗可降低所有主要类型ASCVD女性的全因死亡率和心血管医院再入院率。

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Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease

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Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease

Background

Statin therapy is recommended for secondary prevention of atherosclerotic vascular disease (ASCVD) based on randomized trials, which enrolled mostly men with coronary artery disease (CAD), whereas women and patients with cerebrovascular (CVD) and peripheral artery disease (PAD) were under-represented. We analyzed the effectiveness of statin therapy uptake in a nation-wide cohort of women hospitalized for ASCVD.

Methods

Women hospitalized for CAD, CVD, or PAD, including aortic disease, between 2015 and 2021 were retrospectively identified by linking the national hospital database, medicines reimbursement claims, and national mortality registry. The association of statin uptake within 30 days post-discharge with clinical outcomes (all-cause mortality and cardiovascular hospitalizations) was assessed by Kaplan-Meier curves and Cox proportional hazards regression model with propensity score-derived inverse probability of treatment weights and a 30-day landmark period.

Results

We included 24,665 women with ASCVD – 14,419 with CAD, 5,427 with CVD, and 4,819 with PAD. Overall, the median age was 73 (64–81) years. The rates of statin uptake were 50 % for women with CAD, 60 % for CVD and 28 % for PAD. Statin therapy uptake was associated with a reduction in all-cause mortality and cardiovascular hospitalizations across all three major types of ASCVD: hazard ratio (HR) 0.88, 95 % confidence interval (CI) 0.83–0.93, p = 0.001 for CAD, HR 0.87, 95 % CI 0.80–0.94, p = 0.006 for PAD, and HR 0.72, 95 % CI 0.66–0.78, p < 0.001 for CVD.