Rheumatology Department, San Antonio Uniformed Services Health Education Consortium, San Antonio Military Medical Center, San Antonio, TX, USA.
Am J Cardiol. 2013 Sep 15;112(6):883-8. doi: 10.1016/j.amjcard.2013.04.059. Epub 2013 Jun 11.
Statins have pleiotropic properties that may affect the development of connective tissue diseases (CTD). The objective of this study was to compare the risk of CTD diagnoses in statin users and nonusers. This study was a propensity score-matched analysis of adult patients (30 to 85 years old) in the San Antonio military medical community. The study was divided into baseline (October 1, 2003 to September 30, 2005), and follow-up (October 1, 2005 to March 5, 2010) periods. Statin users received a statin prescription during fiscal year 2005. Nonusers did not receive a statin at any time during the study. The outcome measure was the occurrence of 3 diagnosis codes of the International Classification of Diseases, 9th Revision, Clinical Modification consistent with CTD. We described co-morbidities during the baseline period using the Charlson Comorbidity Index. We created a propensity score based on 41 variables. We then matched statin users and nonusers 1:1, using a caliper of 0.001. Of 46,488 patients who met study criteria (13,640 statin users and 32,848 nonusers), we matched 6,956 pairs of statin users and nonusers. Matched groups were similar in terms of patient age, gender, incidence of co-morbidities, total Charlson Comorbidity Index, health care use, and medication use. The odds ratio for CTD was lower in statin users than nonusers (odds ratio: 0.80; 95% confidence interval: 0.64 to 0.99; p = 0.05). Secondary analysis and sensitivity analysis confirmed these results. In conclusion, statin use was associated with a lower risk of CTD.
他汀类药物具有多种作用，可能影响结缔组织疾病（CTD）的发生。本研究旨在比较他汀类药物使用者和非使用者发生 CTD 的风险。本研究是对圣安东尼奥军事医疗社区 30 至 85 岁成人患者进行的倾向评分匹配分析。研究分为基线期（2003 年 10 月 1 日至 2005 年 9 月 30 日）和随访期（2005 年 10 月 1 日至 2010 年 3 月 5 日）。他汀类药物使用者在 2005 财政年度接受了他汀类药物处方。在研究期间，非使用者任何时候都未接受他汀类药物治疗。结局指标为发生 3 个符合国际疾病分类第 9 版临床修订版的 CTD 诊断代码。我们使用 Charlson 合并症指数描述基线期的合并症。我们根据 41 个变量创建了倾向评分。然后，我们使用 0.001 的卡尺将他汀类药物使用者和非使用者 1:1 匹配。在符合研究标准的 46488 名患者中（13640 名他汀类药物使用者和 32848 名非使用者），我们匹配了 6956 对他汀类药物使用者和非使用者。匹配组在患者年龄、性别、合并症发生率、总 Charlson 合并症指数、医疗保健使用和药物使用方面相似。他汀类药物使用者发生 CTD 的比值比低于非使用者（比值比：0.80；95%置信区间：0.64 至 0.99；p=0.05）。二次分析和敏感性分析证实了这些结果。总之，他汀类药物的使用与 CTD 风险降低相关。
