Statin reduces mortality and morbidity in systemic lupus erythematosus patients with hyperlipidemia: A nationwide population-based cohort study
Journal
Atherosclerosis
Journal Volume
243
Journal Issue
1
Pages
11-18
Date Issued
2015
Abstract
Objective: The anti-inflammatory and cardiovascular protective effects of statin for patients with systemic lupus erythematosus (SLE) are not clear. We tested the hypothesis that statin use is associated with reduced mortality and morbidity in SLE patients with hyperlipidemia. Methods: We included 4095 patients with SLE and hyperlipidemia from the entire population using the Taiwan National Health Insurance Research Database between 1997 and 2008. A total of 935 matching sets (1:2) of patients who had never used lipid-lowering medications and statin users were included in the nested matched cohort. Cox proportional hazards regression was used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for the association between statin and all-cause mortality, coronary artery disease (CAD), cerebrovascular disease (CVD) and end-stage renal disease (ESRD), conditional for matching sets in the matched cohort. Results: The multivariate adjusted hazard ratios (HR) for statin users, as compared with patients had never used lipid-lowering medications, were 0.67 (95% CI, 0.54 to 0.83) for death from any cause. High-dose statins (>365 cumulative defined daily dose) significantly reduced risk of all-cause mortality (HR 0.44, 95% CI 0.32 to 0.60); CAD (HR 0.20, 95% CI 0.13 to 0.31); CVD (HR 0.14, 95% CI 0.08 to 0.25); and ESRD (HR 0.22, 95% CI, 0.16 to 0.29), with similar results in the nested matched study. Conclusion: Statin therapy in SLE patients with hyperlipidemia may reduce the risk of mortality, cardiovascular disease and ESRD. The effect of statins needs to be demonstrated in large prospective studies with long-term follow-up. ? 2015 Published by Elsevier Ireland Ltd.
SDGs
Other Subjects
hydroxymethylglutaryl coenzyme A reductase inhibitor; antiinflammatory agent; hydroxymethylglutaryl coenzyme A reductase inhibitor; immunologic factor; adolescent; adult; Article; cardiovascular risk; cerebrovascular disease; child; cohort analysis; controlled study; coronary artery disease; drug megadose; end stage renal disease; female; human; hyperlipidemia; major clinical study; male; morbidity; mortality; priority journal; risk reduction; systemic lupus erythematosus; Cerebrovascular Disorders; complication; coronary artery disease; dose response; Hyperlipidemias; Kidney Failure, Chronic; middle aged; multivariate analysis; proportional hazards model; register; regression analysis; reproducibility; systemic lupus erythematosus; Taiwan; Adult; Anti-Inflammatory Agents; Cerebrovascular Disorders; Cohort Studies; Coronary Artery Disease; Dose-Response Relationship, Drug; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemias; Immunologic Factors; Kidney Failure, Chronic; Lupus Erythematosus, Systemic; Male; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Registries; Regression Analysis; Reproducibility of Results; Taiwan
Publisher
Elsevier Ireland Ltd
Type
journal article