Impact of Statin Adherence on Cardiovascular Morbidity and All-Cause Mortality in the Primary Prevention of Cardiovascular Disease : A Population-Based Cohort Study in Finland
Copyright © 2015. Published by Elsevier Inc..
OBJECTIVES: To assess the extent to which adherence to statins is associated with the incidence of cardiovascular (CV) events and all-cause mortality in the primary prevention of CV diseases and whether different analytical approaches influence the observed associations.
METHODS: This population-based cohort study used data from Finnish registers. The cohort included 97,575 new statin users aged 45 to 75 years in 2001 to 2004 with no CV diseases at baseline. Exposure was defined as adherence to statins (proportion of days covered [PDC]). The primary outcome was any CV event or death during a 3-year follow-up. Different analytical approaches, including multivariable-adjusted Cox regression, inverse probability weighting with time-varying adherence, and propensity score calibration, were used.
RESULTS: During the first year of follow-up, 53% displayed good (PDC ≥80%), 26% had intermediate (PDC 40%-79%), and 21% exhibited poor (PDC <40%) adherence. After adjustment for sociodemographic and clinical covariates, a 25% relative risk reduction (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.71-0.79) was observed in the rate of any CV event or death among good versus poor adherers. Good adherers also had a lower incidence than poor adherers of acute coronary syndrome (HR 0.56; 95% CI 0.49-0.65) and acute cerebrovascular disease events (HR 0.67; 95% CI 0.60-0.76). The different analytical approaches achieved comparable results for all the outcomes.
CONCLUSIONS: The incidence of CV events and mortality was higher in poor versus good adherers. Different analytical methods that took into account changes in adherence and confounding at baseline did not appreciably affect the results.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2015 |
|---|---|
| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
|---|---|
| Enthalten in: |
Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research - 18(2015), 6 vom: 30. Sept., Seite 896-905 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Rannanheimo, Piia K [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cardiovascular disease |
|---|
| Anmerkungen: |
Date Completed 08.01.2016 Date Revised 28.09.2015 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jval.2015.06.002 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM253129974 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM253129974 | ||
| 003 | DE-627 | ||
| 005 | 20231224165554.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231224s2015 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jval.2015.06.002 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0843.xml |
| 035 | |a (DE-627)NLM253129974 | ||
| 035 | |a (NLM)26409618 | ||
| 035 | |a (PII)S1098-3015(15)01980-4 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Rannanheimo, Piia K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of Statin Adherence on Cardiovascular Morbidity and All-Cause Mortality in the Primary Prevention of Cardiovascular Disease |b A Population-Based Cohort Study in Finland |
| 264 | 1 | |c 2015 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.01.2016 | ||
| 500 | |a Date Revised 28.09.2015 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2015. Published by Elsevier Inc. | ||
| 520 | |a OBJECTIVES: To assess the extent to which adherence to statins is associated with the incidence of cardiovascular (CV) events and all-cause mortality in the primary prevention of CV diseases and whether different analytical approaches influence the observed associations | ||
| 520 | |a METHODS: This population-based cohort study used data from Finnish registers. The cohort included 97,575 new statin users aged 45 to 75 years in 2001 to 2004 with no CV diseases at baseline. Exposure was defined as adherence to statins (proportion of days covered [PDC]). The primary outcome was any CV event or death during a 3-year follow-up. Different analytical approaches, including multivariable-adjusted Cox regression, inverse probability weighting with time-varying adherence, and propensity score calibration, were used | ||
| 520 | |a RESULTS: During the first year of follow-up, 53% displayed good (PDC ≥80%), 26% had intermediate (PDC 40%-79%), and 21% exhibited poor (PDC <40%) adherence. After adjustment for sociodemographic and clinical covariates, a 25% relative risk reduction (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.71-0.79) was observed in the rate of any CV event or death among good versus poor adherers. Good adherers also had a lower incidence than poor adherers of acute coronary syndrome (HR 0.56; 95% CI 0.49-0.65) and acute cerebrovascular disease events (HR 0.67; 95% CI 0.60-0.76). The different analytical approaches achieved comparable results for all the outcomes | ||
| 520 | |a CONCLUSIONS: The incidence of CV events and mortality was higher in poor versus good adherers. Different analytical methods that took into account changes in adherence and confounding at baseline did not appreciably affect the results | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a cardiovascular disease | |
| 650 | 4 | |a healthy adherer effect | |
| 650 | 4 | |a medication adherence | |
| 650 | 4 | |a statins | |
| 650 | 7 | |a Hydroxymethylglutaryl-CoA Reductase Inhibitors |2 NLM | |
| 700 | 1 | |a Tiittanen, Pekka |e verfasserin |4 aut | |
| 700 | 1 | |a Hartikainen, Juha |e verfasserin |4 aut | |
| 700 | 1 | |a Helin-Salmivaara, Arja |e verfasserin |4 aut | |
| 700 | 1 | |a Huupponen, Risto |e verfasserin |4 aut | |
| 700 | 1 | |a Vahtera, Jussi |e verfasserin |4 aut | |
| 700 | 1 | |a Korhonen, Maarit Jaana |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research |d 1998 |g 18(2015), 6 vom: 30. Sept., Seite 896-905 |w (DE-627)NLM115934545 |x 1524-4733 |7 nnns |
| 773 | 1 | 8 | |g volume:18 |g year:2015 |g number:6 |g day:30 |g month:09 |g pages:896-905 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jval.2015.06.002 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 18 |j 2015 |e 6 |b 30 |c 09 |h 896-905 | ||