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Statin adherence and risk of all-cause, cancer, and cardiovascular mortality among dyslipidemia patients: A time-dependent analysis

Authors
 Young Ran Lee  ;  Sarah Soyeon Oh  ;  Sung-In Jang  ;  Eun-Cheol Park 
Citation
 NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, Vol.30(12) : 2207-2214, 2020-11 
Journal Title
 NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES 
ISSN
 0939-4753 
Issue Date
2020-11
Keywords
Cancer mortality ; Cardiovascular mortality ; Dyslipidemia ; Medication adherence ; Statin
Abstract
Background and aim: Results have been mixed and uncertainty still remains regarding the impact of statin adherence on premature deaths. Thus, we investigated the association between statin adherence and risks of all-cause, cancer, and cardiovascular mortality among dyslipidemia patients in South Korea. Methods and results: We used data from the National Health Insurance Service (NHIS) National Sample Cohort for the years 2003-2013, which included data on 107,954 middle-aged and elderly dyslipidemia patients. Among these patients, a time-dependent Cox proportional hazards model was used to estimate the hazard ratios (HRs) of all-cause, cancer, and cardiovascular mortality depending on proportion of days covered (PDC) by statin medication. A total of 3073 (2.85%) individuals died within the study period. Of these individuals, 1143 (1.06%) died from cancer, and 687 (0.64%) died from cardiovascular diseases. Relative to good medication adherence (>80%), moderate (50-80%) (hazard ratio [HR]: 1.28, 95% confidence interval [CI]: 1.14-1.43) and poor (<50%) (HR: 1.58, 95% CI: 1.41-1.78) adherence were associated with increased risk of all-cause mortality. Poor adherence was also associated with increased risk of cancer (HR: 1.33, 95% CI: 1.16-1.52) and cardiovascular (HR: 1.27, 95% CI: 1.06-1.51) mortality. Conclusion: Such findings reveal that relative to good statin adherence, moderate and/poor adherence is associated with increased risks of all-cause, cancer, and cardiovascular mortality. Clinicians should assess for dyslipidemia, link statin adherence problems to potential mortality risk, and monitor outcomes in both medication adherence and disease complications.
Full Text
https://www.sciencedirect.com/science/article/pii/S0939475320302994
DOI
10.1016/j.numecd.2020.07.024
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180736
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