The Journal of clinical endocrinology and metabolism · 2018
Statin Use Is Associated With Decreased Osteoporosis and Fracture Risks in Stroke Patients.
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Lin Shu-Man, Wang Jen-Hung, Liang Chung-Chao, Huang Huei-Kai
Аннотация
CONTEXT: Poststroke osteoporosis and consequent fractures increase the risk of morbidity and mortality and cause considerable socioeconomic burden.
OBJECTIVE: To evaluate the association between statin use and risks of osteoporosis and fracture in stroke patients.
DESIGN: Population-based propensity score‒matched cohort study.
SETTING: Taiwan's National Health Insurance Research Database.
PATIENTS: Patients newly diagnosed with a stroke between 2000 and 2012 were identified. After propensity score matching, 5254 patients were included, with 2627 patients in the statin and nonstatin cohorts, respectively.
MAIN OUTCOME MEASURES: Hazard ratios (HRs) for poststroke osteoporosis, hip fracture, and vertebral fracture (together, the primary outcome) were calculated using Cox proportional hazards regression models according to statin use status.
RESULTS: Poststroke statin use was associated with a lower overall risk of the primary outcome [adjusted hazard ratio (aHR) = 0.66; P < 0.001]. In subanalyses, statin use was associated with a decreased risk of all individual outcomes, including osteoporosis (aHR = 0.68; P < 0.001), hip fracture (aHR = 0.59; P < 0.001), and vertebral fracture (aHR = 0.73; P = 0.003). A dose-effect relationship was identified. The aHRs for developing the primary outcome were 0.96, 0.86, and 0.34 for patients who used 1 to 90, 91 to 365, and >365 cumulative defined daily doses of statins, respectively. These dose-effect relationships were maintained on subgroup analyses stratified by age, sex, and stroke type and sensitivity analyses conducted without propensity score matching.
CONCLUSIONS: Statin use is associated with decreased risks of osteoporosis, hip fracture, and vertebral fracture in stroke patients.
OBJECTIVE: To evaluate the association between statin use and risks of osteoporosis and fracture in stroke patients.
DESIGN: Population-based propensity score‒matched cohort study.
SETTING: Taiwan's National Health Insurance Research Database.
PATIENTS: Patients newly diagnosed with a stroke between 2000 and 2012 were identified. After propensity score matching, 5254 patients were included, with 2627 patients in the statin and nonstatin cohorts, respectively.
MAIN OUTCOME MEASURES: Hazard ratios (HRs) for poststroke osteoporosis, hip fracture, and vertebral fracture (together, the primary outcome) were calculated using Cox proportional hazards regression models according to statin use status.
RESULTS: Poststroke statin use was associated with a lower overall risk of the primary outcome [adjusted hazard ratio (aHR) = 0.66; P < 0.001]. In subanalyses, statin use was associated with a decreased risk of all individual outcomes, including osteoporosis (aHR = 0.68; P < 0.001), hip fracture (aHR = 0.59; P < 0.001), and vertebral fracture (aHR = 0.73; P = 0.003). A dose-effect relationship was identified. The aHRs for developing the primary outcome were 0.96, 0.86, and 0.34 for patients who used 1 to 90, 91 to 365, and >365 cumulative defined daily doses of statins, respectively. These dose-effect relationships were maintained on subgroup analyses stratified by age, sex, and stroke type and sensitivity analyses conducted without propensity score matching.
CONCLUSIONS: Statin use is associated with decreased risks of osteoporosis, hip fracture, and vertebral fracture in stroke patients.