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Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort
BACKGROUND: The effect of statins on all-cause mortality in the general population has been estimated as 0.86 (95%CI 0.79-0.94) for primary prevention. Reported values in HIV-infected individuals have been discordant. We assessed the impact of statin-based primary prevention on all-cause mortality a...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511794/ https://www.ncbi.nlm.nih.gov/pubmed/26200661 http://dx.doi.org/10.1371/journal.pone.0133358 |
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author | Lang, Sylvie Lacombe, Jean-Marc Mary-Krause, Murielle Partisani, Marialuisa Bidegain, Frédéric Cotte, Laurent Aslangul, Elisabeth Chéret, Antoine Boccara, Franck Meynard, Jean-Luc Pradier, Christian Roger, Pierre-Marie Tattevin, Pierre Costagliola, Dominique Molina, Jean-Michel |
author_facet | Lang, Sylvie Lacombe, Jean-Marc Mary-Krause, Murielle Partisani, Marialuisa Bidegain, Frédéric Cotte, Laurent Aslangul, Elisabeth Chéret, Antoine Boccara, Franck Meynard, Jean-Luc Pradier, Christian Roger, Pierre-Marie Tattevin, Pierre Costagliola, Dominique Molina, Jean-Michel |
author_sort | Lang, Sylvie |
collection | PubMed |
description | BACKGROUND: The effect of statins on all-cause mortality in the general population has been estimated as 0.86 (95%CI 0.79-0.94) for primary prevention. Reported values in HIV-infected individuals have been discordant. We assessed the impact of statin-based primary prevention on all-cause mortality among HIV-infected individuals. METHODS: Patients were selected among controls from a multicentre nested case-control study on the risk of myocardial infarction. Patients with prior cardiovascular or cerebrovascular disorders were not eligible. Potential confounders, including variables that were associated either with statin use and/or death occurrence and statin use were evaluated within the last 3 months prior to inclusion in the case-control study. Using an intention to continue approach, multiple imputation of missing data, Cox’s proportional hazard models or propensity based weighting, the impact of statins on the 7-year all-cause mortality was evaluated. RESULTS: Among 1,776 HIV-infected individuals, 138 (8%) were statins users. During a median follow-up of 53 months, 76 deaths occurred, including 6 in statin users. Statin users had more cardiovascular risk factors and a lower CD4 T cell nadir than statin non-users. In univariable analysis, the death rate was higher in statins users (11% vs 7%, HR 1.22, 95%CI 0.53-2.82). The confounders accounted for were age, HIV transmission group, current CD4 T cell count, haemoglobin level, body mass index, smoking status, anti-HCV antibodies positivity, HBs antigen positivity, diabetes and hypertension. In the Cox multivariable model the estimated hazard ratio of statin on all-cause mortality was estimated as 0.86 (95%CI 0.34-2.19) and it was 0.83 (95%CI 0.51-1.35) using inverse probability treatment weights. CONCLUSION: The impact of statin for primary prevention appears similar in HIV-infected individuals and in the general population. |
format | Online Article Text |
id | pubmed-4511794 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-45117942015-07-24 Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort Lang, Sylvie Lacombe, Jean-Marc Mary-Krause, Murielle Partisani, Marialuisa Bidegain, Frédéric Cotte, Laurent Aslangul, Elisabeth Chéret, Antoine Boccara, Franck Meynard, Jean-Luc Pradier, Christian Roger, Pierre-Marie Tattevin, Pierre Costagliola, Dominique Molina, Jean-Michel PLoS One Research Article BACKGROUND: The effect of statins on all-cause mortality in the general population has been estimated as 0.86 (95%CI 0.79-0.94) for primary prevention. Reported values in HIV-infected individuals have been discordant. We assessed the impact of statin-based primary prevention on all-cause mortality among HIV-infected individuals. METHODS: Patients were selected among controls from a multicentre nested case-control study on the risk of myocardial infarction. Patients with prior cardiovascular or cerebrovascular disorders were not eligible. Potential confounders, including variables that were associated either with statin use and/or death occurrence and statin use were evaluated within the last 3 months prior to inclusion in the case-control study. Using an intention to continue approach, multiple imputation of missing data, Cox’s proportional hazard models or propensity based weighting, the impact of statins on the 7-year all-cause mortality was evaluated. RESULTS: Among 1,776 HIV-infected individuals, 138 (8%) were statins users. During a median follow-up of 53 months, 76 deaths occurred, including 6 in statin users. Statin users had more cardiovascular risk factors and a lower CD4 T cell nadir than statin non-users. In univariable analysis, the death rate was higher in statins users (11% vs 7%, HR 1.22, 95%CI 0.53-2.82). The confounders accounted for were age, HIV transmission group, current CD4 T cell count, haemoglobin level, body mass index, smoking status, anti-HCV antibodies positivity, HBs antigen positivity, diabetes and hypertension. In the Cox multivariable model the estimated hazard ratio of statin on all-cause mortality was estimated as 0.86 (95%CI 0.34-2.19) and it was 0.83 (95%CI 0.51-1.35) using inverse probability treatment weights. CONCLUSION: The impact of statin for primary prevention appears similar in HIV-infected individuals and in the general population. Public Library of Science 2015-07-22 /pmc/articles/PMC4511794/ /pubmed/26200661 http://dx.doi.org/10.1371/journal.pone.0133358 Text en © 2015 Lang et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Lang, Sylvie Lacombe, Jean-Marc Mary-Krause, Murielle Partisani, Marialuisa Bidegain, Frédéric Cotte, Laurent Aslangul, Elisabeth Chéret, Antoine Boccara, Franck Meynard, Jean-Luc Pradier, Christian Roger, Pierre-Marie Tattevin, Pierre Costagliola, Dominique Molina, Jean-Michel Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort |
title | Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort |
title_full | Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort |
title_fullStr | Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort |
title_full_unstemmed | Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort |
title_short | Is Impact of Statin Therapy on All-Cause Mortality Different in HIV-Infected Individuals Compared to General Population? Results from the FHDH-ANRS CO4 Cohort |
title_sort | is impact of statin therapy on all-cause mortality different in hiv-infected individuals compared to general population? results from the fhdh-anrs co4 cohort |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511794/ https://www.ncbi.nlm.nih.gov/pubmed/26200661 http://dx.doi.org/10.1371/journal.pone.0133358 |
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