Statin Use Is Associated With a Lower Risk of TB
Statin Use Is Associated With a Lower Risk of TB
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DOI：
10.1016/j.chest.2017.04.170
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发表时间：
2017-09-01
期刊：
影响因子：
9.6
通讯作者：
Chen, Tzeng-Ji
中科院分区：
文献类型：
--
作者：
Su, Vincent Yi-Fong;Su, Wei-Juin;Chen, Tzeng-Ji
背景：他汀类药物被广泛用于降低胆固醇水平和心血管风险。此外，研究表明，他汀类药物可以降低感染疾病和感染相关死亡率的风险；然而，他汀类药物的使用与活动性结核病之间的联系仍不清楚。方法：利用台湾国家健康保险研究数据库，我们进行了一项全国性的以人群为基础的研究。纳入了在2000年至2013年期间服用他汀类药物的患者，这些患者没有既往结核病病史。分析了102,424名他汀类药物使用者和202,718名年龄、性别和登记日期匹配的受试者的数据。在2013年12月31日之前，这两个队列都接受了结核病事件的监测。结果：他汀类和配对队列分别观察了571,568和1,027,385人年。在总计305,142名受试者中，1,264人(0.41%)随后发展为结核病。验证性研究证实了结核病定义的准确性(敏感度，96.3%)，观察者间的一致性很好(k=1.00)。多因素分析显示，他汀类药物组患结核病的风险降低(风险比[HR]，0.53；95%CI，0.47-0.61；P
BACKGROUND: Statins are widely used to lower cholesterol levels and cardiovascular risk. Further, studies have shown that statins may decrease the risks of infectious diseases and infection-related mortality; however, the association between statin use and active TB disease remains unclear.METHODS: Using the Taiwan National Health Insurance Research Database, we conducted a nationwide population-based study. Patients taking statins between 2000 and 2013, without antecedent TB disease, were included. Data from 102,424 statin users and 202,718 age-, sex-, and enrollment date-matched subjects were analyzed. The two cohorts were monitored until December 31, 2013, for incident TB disease. The definition of TB disease was validated using the claims database of Taipei Veterans General Hospital.RESULTS: The statin and matched cohorts were observed for 571,568 and 1,027,385 person-years, respectively. Of the total 305,142 subjects, 1,264 (0.41%) developed subsequent TB disease. Validation study confirmed the accuracy of the definition of TB disease (sensitivity, 96.3%), with excellent interobserver agreement (k = 1.00). Multivariate analysis revealed a reduced risk of TB disease among the statin cohort (hazard ratio [HR], 0.53; 95% CI, 0.47-0.61; P