Effectiveness of Statins for Primary Prevention of Cardiovascular Disease in Low- and Medium-Risk Males: A Causal Inference Approach with Observational Data.

Autor: Chaure-Pardos A; Directorate of Public Health, Government of Aragón, 50017 Zaragoza, Spain.; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain.; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), 50009 Zaragoza, Spain., Aguilar-Palacio I; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain.; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), 50009 Zaragoza, Spain.; Preventive Medicine and Public Health Department, University of Zaragoza, 50009 Zaragoza, Spain., Rabanaque MJ; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain.; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), 50009 Zaragoza, Spain.; Preventive Medicine and Public Health Department, University of Zaragoza, 50009 Zaragoza, Spain., Lallana MJ; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain.; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), 50009 Zaragoza, Spain.; Primary Health Care, Servicio Aragonés de Salud, 50017 Zaragoza, Spain., Maldonado L; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain.; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), 50009 Zaragoza, Spain.; Department of Economic Structure, Economic History and Public Economics, University of Zaragoza, 50009 Zaragoza, Spain., Castel-Feced S; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain.; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), 50009 Zaragoza, Spain.; Preventive Medicine and Public Health Department, University of Zaragoza, 50009 Zaragoza, Spain., Librero J; Unidad de Metodología, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Spain., Casasnovas JA; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain.; Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, 50009 Zaragoza, Spain., Malo S; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain.; Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), 50009 Zaragoza, Spain.; Preventive Medicine and Public Health Department, University of Zaragoza, 50009 Zaragoza, Spain.
Jazyk: angličtina
Zdroj: Journal of personalized medicine [J Pers Med] 2022 Apr 20; Vol. 12 (5). Date of Electronic Publication: 2022 Apr 20.
DOI: 10.3390/jpm12050658
Abstrakt: In this study, we analyzed the effectiveness of statin therapy for the primary prevention of cardiovascular disease (CVD) in low- and medium-risk patients. Using observational data, we estimated effectiveness by emulating a hypothetical randomized clinical trial comparing statin initiators with statin non-initiators. Two approaches were used to adjust for potential confounding factors: matching and inverse probability weighting in marginal structural models. The estimates of effectiveness were obtained by intention-to-treat and per-protocol analysis. The intention-to-treat analysis revealed an absolute risk reduction of 7.2 (95% confidence interval (CI95%), -6.6-21.0) events per 1000 subjects treated for 5 years in the matched design, and 2.2 (CI95%, -3.9-8.2) in the marginal structural model. The per-protocol analysis revealed an absolute risk reduction of 16.7 (CI95%, -3.0-36) events per 1000 subjects treated for 5 years in the matched design and 5.8 (CI95%, 0.3-11.4) in the marginal structural model. The indication for statin treatment for primary prevention in individuals with low and medium cardiovascular risk appears to be inefficient, but improves with better adherence and in subjectvs with higher risk.
Databáze: MEDLINE
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