Long-term use of statins reduces the risk of hospitalization for dementia
Long-term use of statins reduces the risk of hospitalization for dementia
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DOI：
10.1016/j.atherosclerosis.2013.07.009
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发表时间：
2013-10-01
期刊：
影响因子：
5.3
通讯作者：
Mancia, Giuseppe
中科院分区：
文献类型：
--
作者：
Corrao, Giovanni;Ibrahim, Buthaina;Mancia, Giuseppe
背景：痴呆症是一个主要的公共卫生问题，因为它在老年人中的发病率很高，特别是在越来越多的80岁或以上的受试者中。越来越多的证据表明胆固醇可能与痴呆症的发病机制有关，这使得我们评估了服用他汀类药物的时间与痴呆症住院风险之间的关系。方法：开展了一项基于人群的嵌套病例对照研究，纳入了2003至2004年间新接受他汀类药物治疗的152,729名40岁或以上的意大利伦巴第患者。病例是从最初的处方到2010年因痴呆症住院的1380名患者。为每个病例随机选择了多达20名对照组。使用Logistic回归对他汀类药物的累积使用时间与痴呆症风险进行建模。结果：与他汀类药物覆盖极短(小于6个月)的患者相比，覆盖7-24、25-48和>；48个月的患者的风险分别降低了15%(OR：0.85；95%CI：0.74~0.98)、28%(OR：0.72；95%CI：0.61~0.85)和25%(OR：0.75；95%CI：0.61~0.94)。辛伐他汀和阿托伐他汀都与降低痴呆风险有关，而氟伐他汀和普伐他汀则没有类似的证据。结论：长期使用他汀类药物似乎对预防痴呆有效。(C)2013爱思唯尔爱尔兰有限公司。保留所有权利。
Background: Dementia is a major public health problem because of its high prevalence in elderly individuals, particularly in the growing category of subjects aged 80 years or more. There is accumulating evidence that cholesterol may be implicated in the pathogenesis of dementia, and this has led us to assess the relationship between time spent with statins available and the risk of hospitalization for dementia.Methods: A population-based, nested case-control study was carried out by including the cohort of 152,729 patients from Lombardy (Italy) aged 40 years or older who were newly treated with statins between 2003 and 2004. Cases were the 1380 patients who experienced hospitalization for dementia disease from initial prescription until 2010. Up to twenty controls were randomly selected for each case. Logistic regression was used to model the risk of dementia associated with the cumulative time during which statins were available. Monte-Carlo and rule-out sensitivity analyses were performed to account for unmeasured confounders.Results: Compared with patients who had very short statins coverage (less than 6 months), those on 7 -24, 25-48, and >48 months of coverage respectively had risk reductions of 15% (OR: 0.85; 95% CI: 0.74 to 0.98), 28% (OR: 0.72; 95% CI: 0.61 to 0.85), and 25% (OR: 0.75; 95% CI: 0.61 to 0.94). Simvastatin and atorvastatin were both associated with a reduced risk of dementia, while no similar evidence was observed for fluvastatin and pravastatin.Conclusions: Long-term use of statins seems effective for the prevention of dementia. (C) 2013 Elsevier Ireland Ltd. All rights reserved.