Intensive statin regimens for reducing risk of cardiovascular diseases among human immunodeficiency virus-infected population: A nation-wide longitudinal cohort study 2000–2011

Huang tz Ou, Kai Cheng Chang, Chung Yi Li, Chen Yi Yang, Nai Ying Ko

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Abstract

Objective This study evaluated the risk of cardiovascular diseases (CVD) in a statin-treated HIV-infected population and the effects of intensive statin regimens (i.e., high-dose or potency) on CVD risks. Methods 945 HIV-infected patients newly on statin treatment (144, 15.7% with CVD history) were identified from Taiwan's national HIV cohort. Using the median of the first year cumulative statin dosage as a cut-off point, patients were classified into either a high-dose or low-dose group. Patients were also classified as high-potency (i.e., atorvastatin) or low-potency (i.e., pravastatin) statin users. CVD, including ischemic stroke, coronary artery diseases, and heart failure, were identified after statin use to the end of 2011. Cox hazards regression was applied to assess the time-to-event hazards of CVD in association with intensive statin regimens. Results In the HIV-infected population with CVD history, the high-dose group had a lower CVD risk compared to that of the low-dose group (hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.39–1.99). The high-potency group showed a lower CVD risk compared to that of the low-potency group (HR: 0.42, 95% CI: 0.06–3.13). For those without CVD history, the corresponding figures were HR: 0.64 (95% CI: 0.30–1.35) and HR: 0.67 (95% CI: 0.16–2.87). The event rate of new-onset diabetes in high-dose statin group was higher than that in low-dose statin group (15.28% vs. 8.33%), while no muscle complications (i.e., myalgia, myositis, rhabdomyolysis) and dementia were observed in statin users. Conclusions There appears a trend showing a lower CVD risk in HIV patients receiving intensive statin therapy.

Original languageEnglish
Pages (from-to)592-598
Number of pages7
JournalInternational Journal of Cardiology
Volume230
DOIs
Publication statusPublished - 2017 Mar 1

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Longitudinal Studies
Cohort Studies
Cardiovascular Diseases
HIV
Population
Confidence Intervals
Pravastatin
Rhabdomyolysis
Myositis
Myalgia
Taiwan
Dementia
Coronary Artery Disease
Heart Failure
Stroke

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{929d277787b8422bb23b0bc5e44d945f,
title = "Intensive statin regimens for reducing risk of cardiovascular diseases among human immunodeficiency virus-infected population: A nation-wide longitudinal cohort study 2000–2011",
abstract = "Objective This study evaluated the risk of cardiovascular diseases (CVD) in a statin-treated HIV-infected population and the effects of intensive statin regimens (i.e., high-dose or potency) on CVD risks. Methods 945 HIV-infected patients newly on statin treatment (144, 15.7{\%} with CVD history) were identified from Taiwan's national HIV cohort. Using the median of the first year cumulative statin dosage as a cut-off point, patients were classified into either a high-dose or low-dose group. Patients were also classified as high-potency (i.e., atorvastatin) or low-potency (i.e., pravastatin) statin users. CVD, including ischemic stroke, coronary artery diseases, and heart failure, were identified after statin use to the end of 2011. Cox hazards regression was applied to assess the time-to-event hazards of CVD in association with intensive statin regimens. Results In the HIV-infected population with CVD history, the high-dose group had a lower CVD risk compared to that of the low-dose group (hazard ratio [HR]: 0.88, 95{\%} confidence interval [CI]: 0.39–1.99). The high-potency group showed a lower CVD risk compared to that of the low-potency group (HR: 0.42, 95{\%} CI: 0.06–3.13). For those without CVD history, the corresponding figures were HR: 0.64 (95{\%} CI: 0.30–1.35) and HR: 0.67 (95{\%} CI: 0.16–2.87). The event rate of new-onset diabetes in high-dose statin group was higher than that in low-dose statin group (15.28{\%} vs. 8.33{\%}), while no muscle complications (i.e., myalgia, myositis, rhabdomyolysis) and dementia were observed in statin users. Conclusions There appears a trend showing a lower CVD risk in HIV patients receiving intensive statin therapy.",
author = "Ou, {Huang tz} and Chang, {Kai Cheng} and Li, {Chung Yi} and Yang, {Chen Yi} and Ko, {Nai Ying}",
year = "2017",
month = "3",
day = "1",
doi = "10.1016/j.ijcard.2016.12.050",
language = "English",
volume = "230",
pages = "592--598",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Intensive statin regimens for reducing risk of cardiovascular diseases among human immunodeficiency virus-infected population

T2 - A nation-wide longitudinal cohort study 2000–2011

AU - Ou, Huang tz

AU - Chang, Kai Cheng

AU - Li, Chung Yi

AU - Yang, Chen Yi

AU - Ko, Nai Ying

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objective This study evaluated the risk of cardiovascular diseases (CVD) in a statin-treated HIV-infected population and the effects of intensive statin regimens (i.e., high-dose or potency) on CVD risks. Methods 945 HIV-infected patients newly on statin treatment (144, 15.7% with CVD history) were identified from Taiwan's national HIV cohort. Using the median of the first year cumulative statin dosage as a cut-off point, patients were classified into either a high-dose or low-dose group. Patients were also classified as high-potency (i.e., atorvastatin) or low-potency (i.e., pravastatin) statin users. CVD, including ischemic stroke, coronary artery diseases, and heart failure, were identified after statin use to the end of 2011. Cox hazards regression was applied to assess the time-to-event hazards of CVD in association with intensive statin regimens. Results In the HIV-infected population with CVD history, the high-dose group had a lower CVD risk compared to that of the low-dose group (hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.39–1.99). The high-potency group showed a lower CVD risk compared to that of the low-potency group (HR: 0.42, 95% CI: 0.06–3.13). For those without CVD history, the corresponding figures were HR: 0.64 (95% CI: 0.30–1.35) and HR: 0.67 (95% CI: 0.16–2.87). The event rate of new-onset diabetes in high-dose statin group was higher than that in low-dose statin group (15.28% vs. 8.33%), while no muscle complications (i.e., myalgia, myositis, rhabdomyolysis) and dementia were observed in statin users. Conclusions There appears a trend showing a lower CVD risk in HIV patients receiving intensive statin therapy.

AB - Objective This study evaluated the risk of cardiovascular diseases (CVD) in a statin-treated HIV-infected population and the effects of intensive statin regimens (i.e., high-dose or potency) on CVD risks. Methods 945 HIV-infected patients newly on statin treatment (144, 15.7% with CVD history) were identified from Taiwan's national HIV cohort. Using the median of the first year cumulative statin dosage as a cut-off point, patients were classified into either a high-dose or low-dose group. Patients were also classified as high-potency (i.e., atorvastatin) or low-potency (i.e., pravastatin) statin users. CVD, including ischemic stroke, coronary artery diseases, and heart failure, were identified after statin use to the end of 2011. Cox hazards regression was applied to assess the time-to-event hazards of CVD in association with intensive statin regimens. Results In the HIV-infected population with CVD history, the high-dose group had a lower CVD risk compared to that of the low-dose group (hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.39–1.99). The high-potency group showed a lower CVD risk compared to that of the low-potency group (HR: 0.42, 95% CI: 0.06–3.13). For those without CVD history, the corresponding figures were HR: 0.64 (95% CI: 0.30–1.35) and HR: 0.67 (95% CI: 0.16–2.87). The event rate of new-onset diabetes in high-dose statin group was higher than that in low-dose statin group (15.28% vs. 8.33%), while no muscle complications (i.e., myalgia, myositis, rhabdomyolysis) and dementia were observed in statin users. Conclusions There appears a trend showing a lower CVD risk in HIV patients receiving intensive statin therapy.

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