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Long‐Term Effectiveness and Safety of Initiating Statin Therapy After Index Revascularization In Patients With Peripheral Arterial Occlusive Disease
BACKGROUND: An increasing number of patients with a peripheral arterial occlusive disease were put on statins during the past years. This study assessed whether statin therapy was effective and safe for these new users. METHODS AND RESULTS: Using health insurance claims data from Germany’s second‐la...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763713/ https://www.ncbi.nlm.nih.gov/pubmed/33183157 http://dx.doi.org/10.1161/JAHA.120.018338 |
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author | Peters, Frederik Kuchenbecker, Jenny Kreutzburg, Thea Marschall, Ursula Debus, E. Sebastian Behrendt, Christian‐Alexander |
author_facet | Peters, Frederik Kuchenbecker, Jenny Kreutzburg, Thea Marschall, Ursula Debus, E. Sebastian Behrendt, Christian‐Alexander |
author_sort | Peters, Frederik |
collection | PubMed |
description | BACKGROUND: An increasing number of patients with a peripheral arterial occlusive disease were put on statins during the past years. This study assessed whether statin therapy was effective and safe for these new users. METHODS AND RESULTS: Using health insurance claims data from Germany’s second‐largest insurance fund, BARMER, we identified patients with peripheral arterial occlusive disease who had index revascularization between 2008 and 2018 without prior statin therapy. We compared patients with and without statin therapy in addition to antithrombotics during the first quarter after discharge (new users versus nonusers). Outcomes were all‐cause mortality, cardiovascular events, and incident major amputation for effectiveness and incident diabetes mellitus and incident myopathy for safety. Propensity score matching was used to balance the study groups. All analyses were stratified into patients with chronic limb‐threatening ischemia and intermittent claudication. A total of 22 208 patients (mean age 71.1 years and 50.3% women) were included in the study. In 10 922 matched patients, statin initiation was associated with lower all‐cause mortality (chronic limb‐threatening ischemia: hazard ratio [HR], 0.75 [95% CI, 0.68–0.84]; intermittent claudication: HR, 0.80 [95% CI, 0.70–0.92]), lower risk of major amputation in patients with chronic limb‐threatening ischemia (HR, 0.73; 95% CI, 0.58–0.93) and lower risk of cardiovascular events (hazard ratio, 0.80; 95% CI, 0.70–0.92) in patients with intermittent claudication during 5 years of follow‐up. Safety outcomes did not differ among the study groups. CONCLUSIONS: Initiating statin therapy in patients with peripheral arterial occlusive disease after index revascularization is efficient and safe with an effect size comparable to earlier studies. Awareness campaigns for evidence‐based optimal pharmacological treatment among patients are recommended. |
format | Online Article Text |
id | pubmed-7763713 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77637132020-12-28 Long‐Term Effectiveness and Safety of Initiating Statin Therapy After Index Revascularization In Patients With Peripheral Arterial Occlusive Disease Peters, Frederik Kuchenbecker, Jenny Kreutzburg, Thea Marschall, Ursula Debus, E. Sebastian Behrendt, Christian‐Alexander J Am Heart Assoc Original Research BACKGROUND: An increasing number of patients with a peripheral arterial occlusive disease were put on statins during the past years. This study assessed whether statin therapy was effective and safe for these new users. METHODS AND RESULTS: Using health insurance claims data from Germany’s second‐largest insurance fund, BARMER, we identified patients with peripheral arterial occlusive disease who had index revascularization between 2008 and 2018 without prior statin therapy. We compared patients with and without statin therapy in addition to antithrombotics during the first quarter after discharge (new users versus nonusers). Outcomes were all‐cause mortality, cardiovascular events, and incident major amputation for effectiveness and incident diabetes mellitus and incident myopathy for safety. Propensity score matching was used to balance the study groups. All analyses were stratified into patients with chronic limb‐threatening ischemia and intermittent claudication. A total of 22 208 patients (mean age 71.1 years and 50.3% women) were included in the study. In 10 922 matched patients, statin initiation was associated with lower all‐cause mortality (chronic limb‐threatening ischemia: hazard ratio [HR], 0.75 [95% CI, 0.68–0.84]; intermittent claudication: HR, 0.80 [95% CI, 0.70–0.92]), lower risk of major amputation in patients with chronic limb‐threatening ischemia (HR, 0.73; 95% CI, 0.58–0.93) and lower risk of cardiovascular events (hazard ratio, 0.80; 95% CI, 0.70–0.92) in patients with intermittent claudication during 5 years of follow‐up. Safety outcomes did not differ among the study groups. CONCLUSIONS: Initiating statin therapy in patients with peripheral arterial occlusive disease after index revascularization is efficient and safe with an effect size comparable to earlier studies. Awareness campaigns for evidence‐based optimal pharmacological treatment among patients are recommended. John Wiley and Sons Inc. 2020-11-13 /pmc/articles/PMC7763713/ /pubmed/33183157 http://dx.doi.org/10.1161/JAHA.120.018338 Text en © 2020 The Authors and BARMER, Wuppertal, Germany. Published on behalf of the American Heart Association, Inc., by Wiley This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Peters, Frederik Kuchenbecker, Jenny Kreutzburg, Thea Marschall, Ursula Debus, E. Sebastian Behrendt, Christian‐Alexander Long‐Term Effectiveness and Safety of Initiating Statin Therapy After Index Revascularization In Patients With Peripheral Arterial Occlusive Disease |
title | Long‐Term Effectiveness and Safety of Initiating Statin Therapy After Index Revascularization In Patients With Peripheral Arterial Occlusive Disease |
title_full | Long‐Term Effectiveness and Safety of Initiating Statin Therapy After Index Revascularization In Patients With Peripheral Arterial Occlusive Disease |
title_fullStr | Long‐Term Effectiveness and Safety of Initiating Statin Therapy After Index Revascularization In Patients With Peripheral Arterial Occlusive Disease |
title_full_unstemmed | Long‐Term Effectiveness and Safety of Initiating Statin Therapy After Index Revascularization In Patients With Peripheral Arterial Occlusive Disease |
title_short | Long‐Term Effectiveness and Safety of Initiating Statin Therapy After Index Revascularization In Patients With Peripheral Arterial Occlusive Disease |
title_sort | long‐term effectiveness and safety of initiating statin therapy after index revascularization in patients with peripheral arterial occlusive disease |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763713/ https://www.ncbi.nlm.nih.gov/pubmed/33183157 http://dx.doi.org/10.1161/JAHA.120.018338 |
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