Effects of statins on the risks of ischemic stroke and heart disease in human immunodeficiency virus infection, influenza and severe acute respiratory syndrome–associated coronavirus: respiratory virus infection with steroid use

ABSTRACT

Objectives

We sought to fill the research gap on the effects of statins on the risks of ischemic stroke and heart disease among individuals with human immunodeficiency virus infection, influenza, and severe acute respiratory syndrome associated–coronavirus (HIS) disorders.

Methods

We enrolled a HIS cohort treated with statins (n = 4921) and a HIS cohort not treated with statins (n = 4921). The cumulative incidence of ischemic stroke and heart disease was analyzed using a time-dependent Cox proportional regression analysis. We analyzed the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of ischemic stroke and heart disease for statins users relative to nonusers based on sex, age, comorbidities and medications.

Results

The aHR (95% CI) was 0.38 (0.22–0.65) for ischemic stroke. The aHR (95% CI) of heart disease was 0.50 (0.46–0.55). The aHRs (95% CI) of statin users with low, medium, and high adherence (statin use covering <33%, 33%–66%, and >66%, respectively, of the study period) for the risks of ischemic stroke were 0.50 (0.27–0.92), 0.31 (0.10–1.01), and 0.16 (0.04–0.68) and for heart disease were 0.56 (0.51–0.61), 0.40 (0.33–0.48), and 0.44 (0.38–0.51), respectively, compared with statin nonusers.

Conclusion

Statin use was associated with lower aHRs for ischemic stroke and heart disease in those with HIS disorders with comorbidities.

KEYWORDS:

• Ischemic stroke
• heart disease
• coronavirus
• influenza
• human immunodeficiency virus

Disclosure of any financial/other conflicts of interest

The authors have no relevant conflicts of interest to disclose. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW110-TDU-B-212-124,004), China Medical University Hospital (DMR-111-105, DMR-110-089, DMR-111-090, DMR-111-091); Ministry of Science and Technology (MOST 111-2321-B-039-005), Tseng-Lien Lin Foundation, Taichung, Taiwan. The funders had no role in the study design, data collection and analysis, the decision to publish, or preparation of the manuscript. No additional external funding was received for this study.