https://scholars.lib.ntu.edu.tw/handle/123456789/493378
標題: | Statin use and the risk of subsequent hospitalized exacerbations in copd patients with frequent exacerbations | 作者: | HSIAO-YU YANG Pau-Chung CHEN Yang Y.-H. Tsai Y.-H. Lee C.-P. PAU-CHUNG CHEN Chen W.-C. Hsieh M.-J. |
關鍵字: | Chronic obstructive pulmonary disease; Exacerbation; Frequent exacerbator; Statin | 公開日期: | 2020 | 出版社: | Dove Medical Press Ltd. | 卷: | 15 | 起(迄)頁: | 289-299 | 來源出版物: | International Journal of COPD | 摘要: | Rationale: The potential benefits of statins for the prevention of exacerbations in patients with COPD remains controversial. No previous studies have investigated the impact of statins on clinical outcomes in COPD patients with frequent exacerbations. Objective: This study aimed to evaluate the association between the use of statins and the risk of subsequent hospitalized exacerbations in COPD frequent exacerbators. Materials and Methods: We conducted a population-based cohort study using the Taiwan National Health Insurance Research Database. 139,223 COPD patients with a first hospitalized exacerbation between 2004 and 2012 were analyzed. Among them, 35,482 had a second hospitalized exacerbation within a year after the first exacerbation, and were defined as frequent exacerbators. 1:4 propensity score matching was used to create matched samples of statin users and non-users. The competing risk regression analysis model was used to evaluate the association between statin use and exacerbation risk. Results: The use of statins was associated with a significantly reduced risk in subsequent hospitalized exacerbations in COPD patients after their first hospitalized exacerbation (adjusted subdistribution hazard ration [SHR], 0.89; 95% CI, 0.85–0.93, P<0.001). In frequent exacerbators, the SHR for subsequent hospitalized exacerbations in statins users was 0.88 (95% CI, 0.81–0.94, P=0.001). Subgroup analysis among frequent exacerbators demonstrated that the use of statins only provided a protective effect against subsequent hospitalized exacerbations in male patients aged 75 years and older, with coexisting diabetes mellitus, hypertension or cardiovascular disease, and no protective effect was observed in those with lung cancer or depression. Current use of statins was associated with a greater protective effect for reducing subsequent hospitalized exacerbation. Conclusion: The use of statins was associated with a significant reduction in the risk of hospitalized exacerbations in COPD patients after a first hospitalized exacerbation and in specified COPD frequent exacerbators. ? 2020 Lin et al. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85079465932&doi=10.2147%2fCOPD.S229047&partnerID=40&md5=df2799f1f67d67cc512d59d4fecc6d87 https://scholars.lib.ntu.edu.tw/handle/123456789/493378 |
ISSN: | 1176-9106 | DOI: | 10.2147/COPD.S229047 | SDG/關鍵字: | hydroxymethylglutaryl coenzyme A reductase inhibitor; hydroxymethylglutaryl coenzyme A reductase inhibitor; respiratory tract agent; adult; age; aged; Article; cardiovascular disease; chronic obstructive lung disease; clinical outcome; cohort analysis; comorbidity; controlled study; data base; depression; diabetes mellitus; disease association; disease exacerbation; drug use; female; gender; health insurance; hospitalization; human; hypertension; lung cancer; major clinical study; male; middle aged; protection; risk assessment; risk reduction; Taiwan; chronic obstructive lung disease; disease exacerbation; factual database; prognosis; retrospective study; risk assessment; risk factor; time factor; very elderly; Adult; Aged; Aged, 80 and over; Databases, Factual; Disease Progression; Female; Hospitalization; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Middle Aged; Prognosis; Pulmonary Disease, Chronic Obstructive; Respiratory System Agents; Retrospective Studies; Risk Assessment; Risk Factors; Taiwan; Time Factors |
顯示於: | 環境與職業健康科學研究所 |
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