Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort study
The reported beneficial effects of statins on cardiovascular outcome based on risk assessment are inconsistent. Therefore, we investigated statin therapy effectiveness for the primary prevention of cardiovascular disease (CVD), according to the Korean Risk Prediction Model (KRPM). Subjects aged 40–7...
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1024780/full |
| _version_ | 1811192696441667584 |
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| author | In Sun Ryou Ju Young Kim Hwa Yeon Park Sohee Oh Sehun Kim Hwa Jung Kim Hwa Jung Kim |
| author_facet | In Sun Ryou Ju Young Kim Hwa Yeon Park Sohee Oh Sehun Kim Hwa Jung Kim Hwa Jung Kim |
| author_sort | In Sun Ryou |
| collection | DOAJ |
| description | The reported beneficial effects of statins on cardiovascular outcome based on risk assessment are inconsistent. Therefore, we investigated statin therapy effectiveness for the primary prevention of cardiovascular disease (CVD), according to the Korean Risk Prediction Model (KRPM). Subjects aged 40–79 years with low density lipoprotein cholesterol (LDL-C) of < 190 mg/dL and without CVD history were categorized as statin users or non-users using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database, Korea, 2002–2015. The 10-year atherosclerotic CVD (ASCVD) risk was calculated using the validated KRPM and categorized as low, borderline, intermediate, or high-risk groups; the incidence of major adverse cardiovascular events (MACEs) was compared over a mean follow-up period of 5.7 years using Cox proportional hazard models. The MACE incidence risk was decreased in statin users [hazard ratio (HR) 0.90, 95% confidence interval (CI) (0.84–0.98)]. However, there was an increased risk of MACE incidence in low-risk statin users [HR 1.80, 95% CI (1.29–2.52)], and no significant relationship was identified between statin use and MACE in the borderline [HR 1.15, 95% CI (0.86–1.54)] and intermediate-risk [HR 0.94, 95% CI (0.85–1.03)] groups. The risk of MACE incidence decreased only in the high CVD risk group among statin users. Statin use is not associated with MACE reduction in low- to intermediate-risk participants. Therefore, individuals with LDL-C level of < 190 mg/dL and low ASCVD risk should consider statin therapy only when CVD risk is proved obvious using an appropriate ASCVD risk tool. |
| first_indexed | 2024-04-11T23:56:28Z |
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| language | English |
| last_indexed | 2024-04-11T23:56:28Z |
| publishDate | 2022-11-01 |
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| series | Frontiers in Medicine |
| spelling | doaj.art-8854bdf3d0914fb784ef340b8b73fe192022-12-22T03:56:21ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-11-01910.3389/fmed.2022.10247801024780Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort studyIn Sun Ryou0Ju Young Kim1Hwa Yeon Park2Sohee Oh3Sehun Kim4Hwa Jung Kim5Hwa Jung Kim6Department of Family Medicine, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, South KoreaDepartment of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South KoreaCardiovascular Center, Hallym University Medical Center, Seoul, South KoreaDepartment of Preventive Medicine, Ulsan University College of Medicine, Seoul, South KoreaDepartment of Clinical Epidemiology and Biostatistics, ASAN Medical Center, Seoul, South KoreaThe reported beneficial effects of statins on cardiovascular outcome based on risk assessment are inconsistent. Therefore, we investigated statin therapy effectiveness for the primary prevention of cardiovascular disease (CVD), according to the Korean Risk Prediction Model (KRPM). Subjects aged 40–79 years with low density lipoprotein cholesterol (LDL-C) of < 190 mg/dL and without CVD history were categorized as statin users or non-users using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database, Korea, 2002–2015. The 10-year atherosclerotic CVD (ASCVD) risk was calculated using the validated KRPM and categorized as low, borderline, intermediate, or high-risk groups; the incidence of major adverse cardiovascular events (MACEs) was compared over a mean follow-up period of 5.7 years using Cox proportional hazard models. The MACE incidence risk was decreased in statin users [hazard ratio (HR) 0.90, 95% confidence interval (CI) (0.84–0.98)]. However, there was an increased risk of MACE incidence in low-risk statin users [HR 1.80, 95% CI (1.29–2.52)], and no significant relationship was identified between statin use and MACE in the borderline [HR 1.15, 95% CI (0.86–1.54)] and intermediate-risk [HR 0.94, 95% CI (0.85–1.03)] groups. The risk of MACE incidence decreased only in the high CVD risk group among statin users. Statin use is not associated with MACE reduction in low- to intermediate-risk participants. Therefore, individuals with LDL-C level of < 190 mg/dL and low ASCVD risk should consider statin therapy only when CVD risk is proved obvious using an appropriate ASCVD risk tool.https://www.frontiersin.org/articles/10.3389/fmed.2022.1024780/fullatherosclerotic cardiovascular diseasestatinprimary preventionmajor adverse cardiovascular diseaselow-density lipoprotein cholesterol |
| spellingShingle | In Sun Ryou Ju Young Kim Hwa Yeon Park Sohee Oh Sehun Kim Hwa Jung Kim Hwa Jung Kim Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort study Frontiers in Medicine atherosclerotic cardiovascular disease statin primary prevention major adverse cardiovascular disease low-density lipoprotein cholesterol |
| title | Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort study |
| title_full | Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort study |
| title_fullStr | Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort study |
| title_full_unstemmed | Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort study |
| title_short | Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort study |
| title_sort | do statins benefit low risk population for primary prevention of atherosclerotic cardiovascular disease a retrospective cohort study |
| topic | atherosclerotic cardiovascular disease statin primary prevention major adverse cardiovascular disease low-density lipoprotein cholesterol |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1024780/full |
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