Predictors of long-term mortality in new start statin users

Abstract

Background:

Cardiovascular diseases are among the leading causes of death worldwide and studies have found a direct relationship between levels of low-density lipoprotein cholesterol and coronary heart disease. Statins are the most commonly prescribed medications to lower cholesterol, a major controllable risk factor for coronary heart disease.

Objective:

This study aims to find what factors in the first year of statin therapy are predictive of long-term all-cause mortality.

Methods:

Data for this retrospective cohort study were collected on patients identified as new statin users between December 1, 2006 and November 30, 2007 at five Veterans Affairs Healthcare Systems from Southern California and Nevada. Multiple independent variables were assessed utilizing a logistic regression model assessing for all cause mortality at 6 years follow-up. The independent variables included race, age, ethnicity, body mass index, socioeconomic status, and baseline comorbidities. Secondary analysis analyzed high-density lipoprotein levels, adherence, total cholesterol, and triglycerides.

Results:

Increased age, increased medication count, hypertension, diabetes, tobacco use, chronic obstructive pulmonary disease, and congestive heart failure were all associated with an increased risk of mortality. Hispanic ethnicity, Asian race, and increased body mass index were associated with decreased risk of mortality. There were no significant associations between mortality and race, LDL outcomes at 1 year, or annual income level.

Conclusion:

There is clear evidence that statin use is associated with decreased events in cardiovascular disease and total mortality. This study found multiple independent variables as predictors of mortality in new start statin users after a 6 year follow-up, but differences in lipid groups after 1 year were not predictive of long-term mortality in the cohort studied.

Keywords: :

• Predictors
• Mortality
• Statin
• Adherence

Transparency

Declaration of funding

This study was not funded. Skaggs School of Pharmacy and Pharmaceutical Sciences provided funding for the research assistant, as part of their Summer Research Internship Program.

Declaration of financial/other interests

The authors have no relevant financial or other relationships to disclose. JDA Peer Reviewers on this manuscript have received an honorarium from JDA for their review work, but have no other relevant financial relationships to disclose.

Acknowledgements

The authors thank the Skaggs School of Pharmacy and Pharmaceutical Sciences at University of California, San Diego for the summer research grant which funded the work of the research assistant.