Identification of subgroups within a Japanese older adult population for whom statin therapy is effective in reducing mortality
Use of statins for primary prevention can reduce all-cause mortality in Asian elderly populations, but their effect and the specific effective subgroups in the elderly Japanese population remain unclear. This study examined the relationship between statin therapy for primary prevention and mortality...
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| Veröffentlicht in: | PloS one 2023-12, Vol.18 (12), p.e0295052-e0295052 |
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| creator | Funaki, Daito Kaneda, Hideaki Miyakoshi, Akinori Saito, Kohei Sasaki, Hatoko Nakatani, Eiji |
| description | Use of statins for primary prevention can reduce all-cause mortality in Asian elderly populations, but their effect and the specific effective subgroups in the elderly Japanese population remain unclear. This study examined the relationship between statin therapy for primary prevention and mortality reduction in older Japanese adults, and investigated the effective subgroups. The cohort study was conducted using the Shizuoka Kokuho Database (SKDB). Data were compared between the statin-treated group and a non-statin-treated (control) group using the inverse probability of treatment weighting (IPTW) method. In the SKDB cohort aged ≥65 years, new statin use was associated with a decreased risk of all-cause mortality (hazard ratio, 0.40; 95% confidence interval [CI], 0.33–0.48) after IPTW adjustment. The risk difference for mortality at 5 years in the statin-treated group compared with that in the control group was 0.05 (95% CI, 0.04–0.06), and the number needed to treat was 21.20 (95% CI, 18.10–24.70). In conclusion, statin use for primary prevention in older adults may reduce the risk of all-cause mortality in the population without atherosclerotic disease. Furthermore, statin use for primary prevention is feasible in patients aged 75 to |
| doi_str_mv | 10.1371/journal.pone.0295052 |
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This study examined the relationship between statin therapy for primary prevention and mortality reduction in older Japanese adults, and investigated the effective subgroups. The cohort study was conducted using the Shizuoka Kokuho Database (SKDB). Data were compared between the statin-treated group and a non-statin-treated (control) group using the inverse probability of treatment weighting (IPTW) method. In the SKDB cohort aged ≥65 years, new statin use was associated with a decreased risk of all-cause mortality (hazard ratio, 0.40; 95% confidence interval [CI], 0.33–0.48) after IPTW adjustment. The risk difference for mortality at 5 years in the statin-treated group compared with that in the control group was 0.05 (95% CI, 0.04–0.06), and the number needed to treat was 21.20 (95% CI, 18.10–24.70). In conclusion, statin use for primary prevention in older adults may reduce the risk of all-cause mortality in the population without atherosclerotic disease. Furthermore, statin use for primary prevention is feasible in patients aged 75 to <85 years and in patients with comorbidities such as diabetes, or dementia.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0295052</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Adults ; Aged patients ; Alcohol ; Arteriosclerosis ; Atherosclerosis ; Body mass index ; Cholesterol ; Cohort analysis ; Comorbidity ; Comparative analysis ; Confidence intervals ; Confounding (Statistics) ; Consciousness ; Datasets ; Dementia ; Dementia disorders ; Demographic aspects ; Diabetes ; Diabetes mellitus ; Disease prevention ; Drug therapy ; Exercise ; Heart attacks ; Hypertension ; Japan ; Low density lipoprotein ; Metabolic disorders ; Mortality ; Older people ; Patient outcomes ; Pharmaceutical research ; Population ; Population studies ; Prevention ; Risk ; Sensitivity analysis ; Statins ; Statistical analysis ; Statistics ; Subgroups</subject><ispartof>PloS one, 2023-12, Vol.18 (12), p.e0295052-e0295052</ispartof><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Funaki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Funaki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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This study examined the relationship between statin therapy for primary prevention and mortality reduction in older Japanese adults, and investigated the effective subgroups. The cohort study was conducted using the Shizuoka Kokuho Database (SKDB). Data were compared between the statin-treated group and a non-statin-treated (control) group using the inverse probability of treatment weighting (IPTW) method. In the SKDB cohort aged ≥65 years, new statin use was associated with a decreased risk of all-cause mortality (hazard ratio, 0.40; 95% confidence interval [CI], 0.33–0.48) after IPTW adjustment. The risk difference for mortality at 5 years in the statin-treated group compared with that in the control group was 0.05 (95% CI, 0.04–0.06), and the number needed to treat was 21.20 (95% CI, 18.10–24.70). In conclusion, statin use for primary prevention in older adults may reduce the risk of all-cause mortality in the population without atherosclerotic disease. 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one</jtitle><date>2023-12-01</date><risdate>2023</risdate><volume>18</volume><issue>12</issue><spage>e0295052</spage><epage>e0295052</epage><pages>e0295052-e0295052</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Use of statins for primary prevention can reduce all-cause mortality in Asian elderly populations, but their effect and the specific effective subgroups in the elderly Japanese population remain unclear. This study examined the relationship between statin therapy for primary prevention and mortality reduction in older Japanese adults, and investigated the effective subgroups. The cohort study was conducted using the Shizuoka Kokuho Database (SKDB). Data were compared between the statin-treated group and a non-statin-treated (control) group using the inverse probability of treatment weighting (IPTW) method. In the SKDB cohort aged ≥65 years, new statin use was associated with a decreased risk of all-cause mortality (hazard ratio, 0.40; 95% confidence interval [CI], 0.33–0.48) after IPTW adjustment. The risk difference for mortality at 5 years in the statin-treated group compared with that in the control group was 0.05 (95% CI, 0.04–0.06), and the number needed to treat was 21.20 (95% CI, 18.10–24.70). In conclusion, statin use for primary prevention in older adults may reduce the risk of all-cause mortality in the population without atherosclerotic disease. Furthermore, statin use for primary prevention is feasible in patients aged 75 to <85 years and in patients with comorbidities such as diabetes, or dementia.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><doi>10.1371/journal.pone.0295052</doi><tpages>e0295052</tpages><orcidid>https://orcid.org/0009-0009-2566-9839</orcidid><orcidid>https://orcid.org/0000-0002-4876-446X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adults Aged patients Alcohol Arteriosclerosis Atherosclerosis Body mass index Cholesterol Cohort analysis Comorbidity Comparative analysis Confidence intervals Confounding (Statistics) Consciousness Datasets Dementia Dementia disorders Demographic aspects Diabetes Diabetes mellitus Disease prevention Drug therapy Exercise Heart attacks Hypertension Japan Low density lipoprotein Metabolic disorders Mortality Older people Patient outcomes Pharmaceutical research Population Population studies Prevention Risk Sensitivity analysis Statins Statistical analysis Statistics Subgroups |
| title | Identification of subgroups within a Japanese older adult population for whom statin therapy is effective in reducing mortality |
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