ArticleBMJ open2016
Statin adherence and risk of acute cardiovascular events among women: a cohort study accounting for time-dependent confounding affected by previous adherence.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 4 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Mobile phone-based interventions for improving adherence to medication prescribed for the primary prevention of cardiovascular disease in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Systematic review of the predictors of statin adherence for the primary prevention of cardiovascular disease.PloS one · 2019Pooled it
- Mobile phone-based interventions for improving adherence to medication prescribed for the primary prevention of cardiovascular disease in adults.The Cochrane database of systematic reviews · 2018Pooled it
- Pooled it
- The State of Use and Utility of Negative Controls in Pharmacoepidemiologic Studies.American journal of epidemiology · 2024Review
- Towards better reporting of the proportion of days covered method in cardiovascular medication adherence: A scoping review and new tool TEN-SPIDERS.British journal of clinical pharmacology · 2022Article
- Role of Traditional Cardiovascular Risk Factors after Initiation of Statin Therapy: A PharmLines Inception Cohort Study.Cardiovascular therapeutics · 2022Article
- LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model.Scientific reports · 2021Article
- The influence of statin withdrawal and adherence on stroke outcomes.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Article
- Low adherence to statin treatment during the 1st year after an acute myocardial infarction is associated with increased 2nd-year mortality risk-an inverse probability of treatment weighted study on 54 872 patients.European heart journal. Cardiovascular pharmacotherapy · 2021Article
- Noninvasive Ventilation Use in Critically Ill Patients with Acute Asthma Exacerbations.American journal of respiratory and critical care medicine · 2020Article
- Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: a cross-sectional study.Health and quality of life outcomes · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPrevious studies on the effect of statin adherence on cardiovascular events in the primary prevention of cardiovascular disease have adjusted for time-dependent confounding, but potentially introduced bias into their estimates as adherence and confounders were measured simultaneously. We aimed to evaluate the effect when accounting for time-dependent confounding affected by previous adherence as well as time sequence between factors.
designRetrospective cohort study.
settingFinnish healthcare registers.
participantsWomen aged 45-64 years initiating statin use for primary prevention of cardiovascular disease in 2001-2004 (n=42 807). OUTCOMES: Acute cardiovascular event defined as a composite of acute coronary syndrome and acute ischaemic stroke was our primary outcome. Low-energy fractures were used as a negative control outcome to evaluate the healthy-adherer effect.
resultsDuring the 3-year follow-up, 474 women experienced the primary outcome event and 557 suffered a low-energy fracture. The causal HR estimated with marginal structural model for acute cardiovascular events for all the women who remained adherent (proportion of days covered ≥80%) to statin therapy during the previous adherence assessment year was 0.78 (95% CI: 0.65 to 0.94) when compared with everybody remaining non-adherent (proportion of days covered <80%). The result was robust against alternative model specifications. Statin adherers had a potentially reduced risk of experiencing low-energy fractures compared with non-adherers (HR 0.90, 95% CI 0.76 to 1.07).
conclusionsOur study, which took into account the time dependence of adherence and confounders, as well as temporal order between these factors, is support for the concept that adherence to statins in women in primary prevention decreases the risk of acute cardiovascular events by about one-fifth in comparison to non-adherence. However, part of the observed effect of statin adherence on acute cardiovascular events may be due to the healthy-adherer effect.
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