- 32 views
- 38 downloads
Low Statin Persistence Over 36-months is a High-Risk Marker in Adults with Diabetes
-
- Author / Creator
- Doma, Andrew
-
Statin therapy prevents cardiovascular disease (CVD) in adults with diabetes. There is on-going inconsistency between clinical practice guidelines on whether specific LDL-C levels should be targeted in those on statin therapy. Additionally, real world persistence with statin therapy appears to have plateaued.
To examine the real-world effects of statin use and persistence, and LDL-C levels, on CVD risk, we performed a retrospective cohort study using Alberta administrative health data. We included adults with diabetes and no previous history of CVD, who were 50 years old on April 1, 2012, and followed them until March 31, 2019 for a primary composite outcome of MI, stroke, and revascularization. Statin persistence was defined as the number of 6-month periods in the preceding 3 years during which there were one or more statin dispensations with the first documented window of statin use between April 1, 2009 to September 30, 2009. LDL-C levels (categorized as or > 2.0 mmol/L) were obtained from linked laboratory results. We conducted a time-varying Cox proportional hazards regression with adjustment for age, sex, income, intensity of diabetes therapy, and other comorbidities.
We included 72,541 individuals (mean age = 65.4 (SD 8.9), 47.6% female). The overall primary outcome rate was 10.4 per 1,000 person-years. Independent of statin use and other variables, LDL-C 2.0 mmol/L was strongly associated with reduced CVD (adjusted hazard ratio [HR] 0.64 [95% Confidence Interval (CI) 0.59–0.69], p 2.0 mmol/L and documented statin use in only 1-2 six-month periods in the preceding 3 years are at elevated CVD risk, and may benefit from recall for additional CVD risk reduction. -
- Subjects / Keywords
-
- Graduation date
- Fall 2024
-
- Type of Item
- Thesis
-
- Degree
- Master of Science
-
- License
- This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.