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他汀类药物的使用与流感疫苗接种者中需要医学治疗的急性呼吸道疾病。

Statin use and medically attended acute respiratory illness among influenza vaccine recipients.

机构信息

Medicine Services, VA North Texas Health Care System, Dallas, TX, United States; Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States.

Department of Pharmacy Practice, Texas Tech University Health Sciences Center, School of Pharmacy, 5920 Forest Park, Dallas, TX, United States; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, United States.

出版信息

Vaccine. 2019 Oct 16;37(44):6707-6713. doi: 10.1016/j.vaccine.2019.09.024. Epub 2019 Sep 19.

Abstract

BACKGROUND

Previous studies have suggested that statins decrease influenza vaccine effectiveness and increase risk of medically attended acute respiratory illness (MAARI).

OBJECTIVES

To examine the association of incident statin use and MAARI in a cohort of influenza vaccine recipients.

METHODS

This retrospective cohort study evaluated influenza vaccine recipients within the Tricare population. The primary outcome compared MAARI incidence during the follow-up period in a propensity score-matched cohort of incident statin users and statin non-users. Secondary analysis included propensity score-adjusted comparisons between incident statin users and statin non-users in the entire cohort and prespecified sub-cohorts with and without comorbidities. The propensity score was derived from 72 variables encompassing demographics, medical history, comorbidities, medication use, and healthcare utilization.

RESULTS

MAARI incidence in statin users was similar to non-users in the propensity score-matched cohort (odds ratio [OR] 0.92; 95% confidence interval [CI] 0.84-1.01). In contrast, statin users with lower comorbidity had lower OR for MAARI compared to non-users (Charlson Score zero cohort: 0.85 [CI 0.74-0.98]; No Diabetes cohort: 0.88 [CI 0.80-0.96]).

CONCLUSION

Incident statin use was not associated with increased MAARI incidence and may be associated with lower incidence of MAARI in those with less comorbidity. This study thus offers reassurance regarding the effectiveness of the influenza vaccine in statin users.

摘要

背景

先前的研究表明,他汀类药物会降低流感疫苗的效果,并增加因急性呼吸道疾病而就医(MAARI)的风险。

目的

在流感疫苗接种者队列中研究他汀类药物新使用者与 MAARI 的相关性。

方法

这项回顾性队列研究评估了 Tricare 人群中的流感疫苗接种者。主要结局是在他汀类药物新使用者和他汀类药物未使用者的倾向评分匹配队列中,比较随访期间 MAARI 的发生率。次要分析包括在整个队列中和有或无合并症的预设亚队列中,对他汀类药物新使用者和他汀类药物未使用者进行倾向评分调整比较。倾向评分源自包含人口统计学、病史、合并症、用药和医疗保健使用情况在内的 72 个变量。

结果

在倾向评分匹配的队列中,他汀类药物使用者的 MAARI 发生率与未使用者相似(比值比 [OR] 0.92;95%置信区间 [CI] 0.84-1.01)。相比之下,在合并症较少的他汀类药物使用者中,MAARI 的 OR 低于未使用者(Charlson 评分零队列:0.85 [CI 0.74-0.98];无糖尿病队列:0.88 [CI 0.80-0.96])。

结论

他汀类药物新使用者与 MAARI 发生率增加无关,并且可能与合并症较少者 MAARI 发生率降低有关。因此,该研究为他汀类药物使用者的流感疫苗有效性提供了保证。

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