Long-Term Outcomes of Short-Term Statin Use in Healthy Adults: A Retrospective Cohort Study

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Abstract

Introduction: Data suggest that the beneficial cardiovascular effects of statins are maximized after the first year of statin use; yet, the timeline of statin-associated adverse events is not well delineated. Objective: To examine the associations of short-term statin use (≤1 year) with short- and long-term adverse events and beneficial cardiovascular outcomes in a ‘healthy’ cohort. Participants and Methods: A cohort study of a healthy Tricare population (fiscal year [FY] 2002 through FY 2011) who have no cardiovascular disease, major comorbidities requiring medications, or functional limitations. Statin users used statins for 90–365 days during FY 2005 as their only prescription medication. Nonusers had medical encounters but did not receive prescription medications during FY 2005, and did not receive any statins throughout the study period from FY 2002 to FY 2011. Outcomes were the occurrence of major acute cardiovascular events, diabetes mellitus and its complications, kidney diseases, musculoskeletal diseases, obesity, cataracts, malignancy, and death. Results: We matched 1525 statin users to 1525 nonusers. During the follow-up period (FY 2006 to FY 2011), statin users had significantly higher odds of developing diabetes and diabetic complications that persisted throughout follow-up (odds ratio [OR] 1.93, 95 % confidence interval [CI] 1.55–2.41 and OR 2.15, 95 % CI 1.20–3.86, respectively). Short-term statin use was not associated with decreased odds of major acute cardiovascular events (OR 1.17, 95 % CI 0.72–1.92). There were no differences in risks of kidney diseases, musculoskeletal diseases, or malignancy. Conclusions: Short-term statin use for primary prevention in this healthy cohort was associated with an increased risk of long-term diabetes and diabetic complications without cardiovascular benefits. Further study using pragmatic studies and prospective observational studies appropriately equipped to eliminate unidentified confounders are urgently needed.

Original languageEnglish (US)
Pages (from-to)1-17
Number of pages17
JournalDrug Safety
DOIs
StateAccepted/In press - Mar 15 2016

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cohort Studies
Retrospective Studies
Diabetes Complications
Medical problems
Musculoskeletal Diseases
Odds Ratio
Kidney Diseases
Confidence Intervals
Prescriptions
Primary Prevention
Cataract
Observational Studies
Comorbidity
Neoplasms
Cardiovascular Diseases
Obesity

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Toxicology

Cite this

@article{e5bebacdc574483b92f8eec9dbfb2dd7,
title = "Long-Term Outcomes of Short-Term Statin Use in Healthy Adults: A Retrospective Cohort Study",
abstract = "Introduction: Data suggest that the beneficial cardiovascular effects of statins are maximized after the first year of statin use; yet, the timeline of statin-associated adverse events is not well delineated. Objective: To examine the associations of short-term statin use (≤1 year) with short- and long-term adverse events and beneficial cardiovascular outcomes in a ‘healthy’ cohort. Participants and Methods: A cohort study of a healthy Tricare population (fiscal year [FY] 2002 through FY 2011) who have no cardiovascular disease, major comorbidities requiring medications, or functional limitations. Statin users used statins for 90–365 days during FY 2005 as their only prescription medication. Nonusers had medical encounters but did not receive prescription medications during FY 2005, and did not receive any statins throughout the study period from FY 2002 to FY 2011. Outcomes were the occurrence of major acute cardiovascular events, diabetes mellitus and its complications, kidney diseases, musculoskeletal diseases, obesity, cataracts, malignancy, and death. Results: We matched 1525 statin users to 1525 nonusers. During the follow-up period (FY 2006 to FY 2011), statin users had significantly higher odds of developing diabetes and diabetic complications that persisted throughout follow-up (odds ratio [OR] 1.93, 95 {\%} confidence interval [CI] 1.55–2.41 and OR 2.15, 95 {\%} CI 1.20–3.86, respectively). Short-term statin use was not associated with decreased odds of major acute cardiovascular events (OR 1.17, 95 {\%} CI 0.72–1.92). There were no differences in risks of kidney diseases, musculoskeletal diseases, or malignancy. Conclusions: Short-term statin use for primary prevention in this healthy cohort was associated with an increased risk of long-term diabetes and diabetic complications without cardiovascular benefits. Further study using pragmatic studies and prospective observational studies appropriately equipped to eliminate unidentified confounders are urgently needed.",
author = "Mansi, {Ishak A.} and Jenny English and Song Zhang and Mortensen, {Eric M.} and Halm, {Ethan A.}",
year = "2016",
month = "3",
day = "15",
doi = "10.1007/s40264-016-0412-2",
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journal = "Drug Safety",
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TY - JOUR

T1 - Long-Term Outcomes of Short-Term Statin Use in Healthy Adults

T2 - A Retrospective Cohort Study

AU - Mansi, Ishak A.

AU - English, Jenny

AU - Zhang, Song

AU - Mortensen, Eric M.

AU - Halm, Ethan A.

PY - 2016/3/15

Y1 - 2016/3/15

N2 - Introduction: Data suggest that the beneficial cardiovascular effects of statins are maximized after the first year of statin use; yet, the timeline of statin-associated adverse events is not well delineated. Objective: To examine the associations of short-term statin use (≤1 year) with short- and long-term adverse events and beneficial cardiovascular outcomes in a ‘healthy’ cohort. Participants and Methods: A cohort study of a healthy Tricare population (fiscal year [FY] 2002 through FY 2011) who have no cardiovascular disease, major comorbidities requiring medications, or functional limitations. Statin users used statins for 90–365 days during FY 2005 as their only prescription medication. Nonusers had medical encounters but did not receive prescription medications during FY 2005, and did not receive any statins throughout the study period from FY 2002 to FY 2011. Outcomes were the occurrence of major acute cardiovascular events, diabetes mellitus and its complications, kidney diseases, musculoskeletal diseases, obesity, cataracts, malignancy, and death. Results: We matched 1525 statin users to 1525 nonusers. During the follow-up period (FY 2006 to FY 2011), statin users had significantly higher odds of developing diabetes and diabetic complications that persisted throughout follow-up (odds ratio [OR] 1.93, 95 % confidence interval [CI] 1.55–2.41 and OR 2.15, 95 % CI 1.20–3.86, respectively). Short-term statin use was not associated with decreased odds of major acute cardiovascular events (OR 1.17, 95 % CI 0.72–1.92). There were no differences in risks of kidney diseases, musculoskeletal diseases, or malignancy. Conclusions: Short-term statin use for primary prevention in this healthy cohort was associated with an increased risk of long-term diabetes and diabetic complications without cardiovascular benefits. Further study using pragmatic studies and prospective observational studies appropriately equipped to eliminate unidentified confounders are urgently needed.

AB - Introduction: Data suggest that the beneficial cardiovascular effects of statins are maximized after the first year of statin use; yet, the timeline of statin-associated adverse events is not well delineated. Objective: To examine the associations of short-term statin use (≤1 year) with short- and long-term adverse events and beneficial cardiovascular outcomes in a ‘healthy’ cohort. Participants and Methods: A cohort study of a healthy Tricare population (fiscal year [FY] 2002 through FY 2011) who have no cardiovascular disease, major comorbidities requiring medications, or functional limitations. Statin users used statins for 90–365 days during FY 2005 as their only prescription medication. Nonusers had medical encounters but did not receive prescription medications during FY 2005, and did not receive any statins throughout the study period from FY 2002 to FY 2011. Outcomes were the occurrence of major acute cardiovascular events, diabetes mellitus and its complications, kidney diseases, musculoskeletal diseases, obesity, cataracts, malignancy, and death. Results: We matched 1525 statin users to 1525 nonusers. During the follow-up period (FY 2006 to FY 2011), statin users had significantly higher odds of developing diabetes and diabetic complications that persisted throughout follow-up (odds ratio [OR] 1.93, 95 % confidence interval [CI] 1.55–2.41 and OR 2.15, 95 % CI 1.20–3.86, respectively). Short-term statin use was not associated with decreased odds of major acute cardiovascular events (OR 1.17, 95 % CI 0.72–1.92). There were no differences in risks of kidney diseases, musculoskeletal diseases, or malignancy. Conclusions: Short-term statin use for primary prevention in this healthy cohort was associated with an increased risk of long-term diabetes and diabetic complications without cardiovascular benefits. Further study using pragmatic studies and prospective observational studies appropriately equipped to eliminate unidentified confounders are urgently needed.

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U2 - 10.1007/s40264-016-0412-2

DO - 10.1007/s40264-016-0412-2

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