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Statin Safety in Chinese: A Population-Based Study of Older Adults

BACKGROUND: Compared to Caucasians, Chinese achieve a higher blood concentration of statin for a given dose. It remains unknown whether this translates to increased risk of serious statin-associated adverse events amongst Chinese patients. METHODS: We conducted a population-based retrospective cohor...

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Autores principales: Li, Daniel Q., Kim, Richard B., McArthur, Eric, Fleet, Jamie L., Hegele, Robert A., Shah, Baiju R., Weir, Matthew A., Molnar, Amber O., Dixon, Stephanie, Tu, Jack V., Anand, Sonia, Garg, Amit X.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783028/
https://www.ncbi.nlm.nih.gov/pubmed/26954681
http://dx.doi.org/10.1371/journal.pone.0150990
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author Li, Daniel Q.
Kim, Richard B.
McArthur, Eric
Fleet, Jamie L.
Hegele, Robert A.
Shah, Baiju R.
Weir, Matthew A.
Molnar, Amber O.
Dixon, Stephanie
Tu, Jack V.
Anand, Sonia
Garg, Amit X.
author_facet Li, Daniel Q.
Kim, Richard B.
McArthur, Eric
Fleet, Jamie L.
Hegele, Robert A.
Shah, Baiju R.
Weir, Matthew A.
Molnar, Amber O.
Dixon, Stephanie
Tu, Jack V.
Anand, Sonia
Garg, Amit X.
author_sort Li, Daniel Q.
collection PubMed
description BACKGROUND: Compared to Caucasians, Chinese achieve a higher blood concentration of statin for a given dose. It remains unknown whether this translates to increased risk of serious statin-associated adverse events amongst Chinese patients. METHODS: We conducted a population-based retrospective cohort study of older adults (mean age, 74 years) newly prescribed a statin in Ontario, Canada between 2002 and 2013, where 19,033 Chinese (assessed through a validated surname algorithm) were matched (1:3) by propensity score to 57,099 non-Chinese. This study used linked healthcare databases. FINDINGS: The follow-up observation period (mean 1.1, maximum 10.8 years) was similar between groups, as were the reasons for censoring the observation period (end of follow-up, death, or statin discontinuation). Forty-seven percent (47%) of Chinese were initiated on a higher than recommended statin dose. Compared to non-Chinese, Chinese ethnicity did not associate with any of the four serious statin-associated adverse events assessed in this study [rhabdomyolysis hazard ratio (HR) 0.61 (95% CI 0.28 to 1.34), incident diabetes HR 1.02 (95% CI 0.80 to 1.30), acute kidney injury HR 0.90 (95% CI 0.72 to 1.13), or all-cause mortality HR 0.88 (95% CI 0.74 to 1.05)]. Similar results were observed in subgroups defined by statin type and dose. CONCLUSIONS: We observed no higher risk of serious statin toxicity in Chinese than matched non-Chinese older adults with similar indicators of baseline health. Regulatory agencies should review available data, including findings from our study, to decide if a change in their statin dosing recommendations for people of Chinese ethnicity is warranted.
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spelling pubmed-47830282016-03-23 Statin Safety in Chinese: A Population-Based Study of Older Adults Li, Daniel Q. Kim, Richard B. McArthur, Eric Fleet, Jamie L. Hegele, Robert A. Shah, Baiju R. Weir, Matthew A. Molnar, Amber O. Dixon, Stephanie Tu, Jack V. Anand, Sonia Garg, Amit X. PLoS One Research Article BACKGROUND: Compared to Caucasians, Chinese achieve a higher blood concentration of statin for a given dose. It remains unknown whether this translates to increased risk of serious statin-associated adverse events amongst Chinese patients. METHODS: We conducted a population-based retrospective cohort study of older adults (mean age, 74 years) newly prescribed a statin in Ontario, Canada between 2002 and 2013, where 19,033 Chinese (assessed through a validated surname algorithm) were matched (1:3) by propensity score to 57,099 non-Chinese. This study used linked healthcare databases. FINDINGS: The follow-up observation period (mean 1.1, maximum 10.8 years) was similar between groups, as were the reasons for censoring the observation period (end of follow-up, death, or statin discontinuation). Forty-seven percent (47%) of Chinese were initiated on a higher than recommended statin dose. Compared to non-Chinese, Chinese ethnicity did not associate with any of the four serious statin-associated adverse events assessed in this study [rhabdomyolysis hazard ratio (HR) 0.61 (95% CI 0.28 to 1.34), incident diabetes HR 1.02 (95% CI 0.80 to 1.30), acute kidney injury HR 0.90 (95% CI 0.72 to 1.13), or all-cause mortality HR 0.88 (95% CI 0.74 to 1.05)]. Similar results were observed in subgroups defined by statin type and dose. CONCLUSIONS: We observed no higher risk of serious statin toxicity in Chinese than matched non-Chinese older adults with similar indicators of baseline health. Regulatory agencies should review available data, including findings from our study, to decide if a change in their statin dosing recommendations for people of Chinese ethnicity is warranted. Public Library of Science 2016-03-08 /pmc/articles/PMC4783028/ /pubmed/26954681 http://dx.doi.org/10.1371/journal.pone.0150990 Text en © 2016 Li 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 (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Li, Daniel Q.
Kim, Richard B.
McArthur, Eric
Fleet, Jamie L.
Hegele, Robert A.
Shah, Baiju R.
Weir, Matthew A.
Molnar, Amber O.
Dixon, Stephanie
Tu, Jack V.
Anand, Sonia
Garg, Amit X.
Statin Safety in Chinese: A Population-Based Study of Older Adults
title Statin Safety in Chinese: A Population-Based Study of Older Adults
title_full Statin Safety in Chinese: A Population-Based Study of Older Adults
title_fullStr Statin Safety in Chinese: A Population-Based Study of Older Adults
title_full_unstemmed Statin Safety in Chinese: A Population-Based Study of Older Adults
title_short Statin Safety in Chinese: A Population-Based Study of Older Adults
title_sort statin safety in chinese: a population-based study of older adults
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4783028/
https://www.ncbi.nlm.nih.gov/pubmed/26954681
http://dx.doi.org/10.1371/journal.pone.0150990
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