Risk of intracranial hemorrhage from statin use in Asians: A nationwide cohort study
Journal
Circulation
Journal Volume
131
Journal Issue
23
Pages
2070-2078
Date Issued
2015
Author(s)
Abstract
Background-Reports of statin usage and increased risk of intracranial hemorrhage (ICH) have been inconsistent. This study examined potential associations between statin usage and the risk of ICH in subjects without a previous history of stroke. Methods and Results-Patients initiating statin therapy between 2005 and 2009 without a previous history of ischemic or hemorrhagic stroke were identified from Taiwan's National Health Insurance database. Participants were stratified by advanced age (?70 years), sex, and diagnosed hypertension. The outcome of interest was hospital admission foRiCH (International Classification of Diseases, Ninth Revision, Clinical Modification codes 430, 431, 432). Cox regression models were applied to estimate the hazard ratio of ICH. The cumulative statin dosage stratified by quartile and adjusted for baseline disease risk score served as the primary variable using the lowest quartile of cumulative dosage as a reference. There were 1 096 547 statin initiators with an average follow-up of 3.3 years. The adjusted hazard ratio foRiCH between the highest and the lowest quartile was nonsignificant at 1.06 with a 95% confidence interval spanning 1.00 (0.94-1.19). Similar nonsignificant results were found in sensitivity analyses using different outcome definitions or model adjustments, reinforcing the robustness of the study findings. Subgroup analysis identified an excess of ICH frequency in patients without diagnosed hypertension (adjusted hazard ratio 1.36 [1.11-1.67]). Conclusions-In general, no association was observed between cumulative statin use and the risk of ICH among subjects without a previous history of stroke. An increased risk was identified among the nonhypertensive cohort, but this finding should be interpreted with caution. ? 2015 American Heart Association, Inc.
SDGs
Other Subjects
hydroxymethylglutaryl coenzyme A reductase inhibitor; hydroxymethylglutaryl coenzyme A reductase inhibitor; adult; aged; Article; Asian; brain hemorrhage; brain ischemia; drug use; female; follow up; hazard ratio; hospital admission; human; hypertension; major clinical study; male; priority journal; risk assessment; sensitivity analysis; Taiwan; Cardiovascular Diseases; cohort analysis; dose response; hypercholesterolemia; incidence; Intracranial Hemorrhages; middle aged; proportional hazards model; retrospective study; risk factor; Cardiovascular Diseases; Cohort Studies; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Incidence; Intracranial Hemorrhages; Male; Middle Aged; Proportional Hazards Models; Retrospective Studies; Risk Factors; Taiwan
Publisher
Lippincott Williams and Wilkins
Type
journal article