Yeh Jun-Jun, Syue Shih-Huei, Lin Cheng-Li, Hsu Chung Y, Shae Zonyin, Kao Chia-Hung
Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.
Department of Childhood Education and Nursery, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Front Pharmacol. 2019 Aug 16;10:889. doi: 10.3389/fphar.2019.00889. eCollection 2019.
The effects of statins on the risk of hepatic, renal, respiratory, and heart failure among patients with asthma-chronic obstructive pulmonary disease overlap (ACO) have not been reported. Time-dependent population-based study. Patient data from 2000 to 2010 were retrieved from the Taiwan National Health Insurance Research Database. We divided patients with ACO into cohorts of statin use (N = 1,211) and nonuse (N = 7,443). The cumulative incidence rates of hepatic, renal, respiratory, and heart failure were analyzed through Cox proportional regression analysis with time-dependent variables. After adjustment for multiple confounding factors, including age, sex, comorbidities, and medications [statins, inhaled corticosteroid (ICS), or oral steroid (OS)], the adjusted hazard ratios (aHRs) [95% confidence intervals (CIs)] for hepatic, renal, respiratory, and heart failure were 0.50 (0.40-0.64), 0.49 (0.38-0.64), 0.61 (0.27-2.21), and 0.47 (0.37-0.60), respectively. The aHRs (95% CIs) for statin use with [ICS, OS] for hepatic, renal, and heart failure were [0.36 (0.20-0.66), 0.52 (0.39-0.70)]; [0.82 (0.51-1.34), 0.46 (0.33-0.63)]; and [0.66 (0.40-1.07), 0.48 (0.37-0.64)], respectively. The ACO cohort with statin use exhibited lower risk of hepatic, renal, and heart failure than any other cohort, regardless of age, sex, comorbidities, or ICS or OS use. Regarding the combined use of statins and ICS, the risks of hepatic failure were lower. For the combined use of statins and OS, hepatic, renal, and heart failure were less frequent.
他汀类药物对哮喘-慢性阻塞性肺疾病重叠综合征(ACO)患者发生肝、肾、呼吸及心力衰竭风险的影响尚未见报道。基于人群的时间依赖性研究。从台湾全民健康保险研究数据库中检索2000年至2010年的患者数据。我们将ACO患者分为他汀类药物使用组(N = 1211)和非使用组(N = 7443)。通过带有时间依赖性变量的Cox比例回归分析来分析肝、肾、呼吸及心力衰竭的累积发病率。在对包括年龄、性别、合并症及药物治疗[他汀类药物、吸入性糖皮质激素(ICS)或口服糖皮质激素(OS)]等多个混杂因素进行校正后,肝、肾、呼吸及心力衰竭的校正风险比(aHRs)[95%置信区间(CIs)]分别为0.50(0.40 - 0.64)、0.49(0.38 - 0.64)、0.61(0.27 - 2.21)和0.47(0.37 - 0.60)。他汀类药物与[ICS、OS]联合使用时,肝、肾及心力衰竭的aHRs(95% CIs)分别为[0.36(0.20 - 0.66),0.52(0.39 - 0.70)];[0.82(0.51 - 1.34),0.46(0.33 - 0.63)];以及[0.66(0.40 - 1.07),0.48(0.37 - 0.64)]。无论年龄、性别、合并症或是否使用ICS或OS,使用他汀类药物的ACO组发生肝、肾及心力衰竭的风险均低于其他组。关于他汀类药物与ICS联合使用,肝衰竭风险较低。对于他汀类药物与OS联合使用,肝、肾及心力衰竭的发生频率较低。