Ribe Anette Riisgaard, Vestergaard Claus Høstrup, Vestergaard Mogens, Fenger-Grøn Morten, Pedersen Henrik Schou, Lietzen Lone Winther, Brynningsen Peter Krogh
Research Unit for General Practice, Aarhus, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark.
EClinicalMedicine. 2019 Mar 13;8:78-84. doi: 10.1016/j.eclinm.2019.02.007. eCollection 2019 Feb.
Statins may increase the risk of intracerebral haemorrhage (ICH) in individuals with previous stroke. It remains unclear whether this applies to individuals with no history of stroke. This study is the first to explore the statin-associated risk of ICH in stroke-free individuals while considering the timing of statin initiation.
We conducted a population-based, propensity score matched cohort study using information from five Danish national registers. We included all stroke-free individuals initiating statins in 2004-2013 and a propensity score matched group of non-users. Adjusted hazard ratios (aHRs) for ICH risk among statin users compared to non-users were calculated as a function of time since statin initiation.
519,894 stroke-free individuals initiating statins and their 1:5 matched stroke-free reference subjects were included and followed for up to ten years. During this period, 1409 ICHs occurred in statin users. Statin users had an overall aHR of 0.85 (95% confidence interval: 0.80-0.90) compared to non-users, but this risk was modified by time since statin initiation. Statin users and non-users had similar ICH risk during the first six months after statin initiation. Hereafter, statin users had a 22-35% lower risk throughout the study period.
Statin users had lower ICH risk than non-users from six months after statin initiation. This finding could not be explained by healthy initiator bias or differences between users and non-users in terms of sociodemographic characteristics, comorbidity, or parallel treatment regimens. Our study suggests that statin use in stroke-free populations is associated with reduced ICH risk.
The Novo Nordisk Foundation.
他汀类药物可能会增加既往有卒中史个体发生脑出血（ICH）的风险。目前尚不清楚这是否适用于无卒中史的个体。本研究首次探讨了在无卒中个体中他汀类药物相关的ICH风险，并考虑了他汀类药物起始使用的时间。
我们利用来自丹麦五个国家登记处的信息进行了一项基于人群的倾向评分匹配队列研究。我们纳入了2004年至2013年开始使用他汀类药物的所有无卒中个体以及一个倾向评分匹配的未使用者组。计算他汀类药物使用者与未使用者相比发生ICH风险的调整后风险比（aHRs），作为自他汀类药物起始使用以来时间的函数。
纳入了519894名开始使用他汀类药物的无卒中个体及其1:5匹配的无卒中对照对象，并随访了长达十年。在此期间，他汀类药物使用者中有1409例发生ICH。与未使用者相比，他汀类药物使用者的总体aHR为0.85（95%置信区间：0.80 - 0.90），但该风险因自他汀类药物起始使用以来的时间而有所改变。在他汀类药物起始使用后的前六个月，他汀类药物使用者和未使用者的ICH风险相似。此后，在整个研究期间，他汀类药物使用者的风险降低了22% - 35%。
自他汀类药物起始使用六个月后，他汀类药物使用者的ICH风险低于未使用者。这一发现无法用健康起始者偏倚或使用者与未使用者在社会人口学特征、合并症或并行治疗方案方面的差异来解释。我们的研究表明，在无卒中人群中使用他汀类药物与降低ICH风险相关。
诺和诺德基金会。
Zotero 插件