Gillard Kristin K, Bloedon LeAnne, Grady-Benson John C, Edwards Alison, Fahy Sean, Sasiela William J, Louie Michael J, Thompson Paul D
Esperion Therapeutics Inc., Ann Arbor, MI, USA.
, 245 Lindero Avenue, Long Beach, CA, 90803, USA.
Cardiol Ther. 2024 Sep;13(3):575-591. doi: 10.1007/s40119-024-00374-5. Epub 2024 Jul 14.
The prevalence of tendon rupture and tendinopathies (TRT) has not been determined in a large population of patients with atherosclerotic cardiovascular disease (ASCVD). We investigated TRT prevalence among patients with ASCVD and in the general population, using data from the Symphony Health Integrated Dataverse, a large US medical and pharmacy claims database.
This retrospective, observational study included patients aged ≥ 19 years from the claims database during the identification period (January 2019 to December 2020) and 12 months of continuous enrollment. The primary outcome was evidence of TRT in the 12 months following the index date (first ASCVD diagnosis in the ASCVD cohort; first claim in the claims database in the overall population). Diagnostic codes (ICD-10 and/or CPT) were used to define ASCVD and TRT diagnosis.
The ASCVD cohort and overall population included 5,589,273 and 61,715,843 patients, respectively. In the ASCVD cohort, use of medications with a potential or known association with TRT was identified in 67.9% (statins), 17.7% (corticosteroids), and 16.7% (fluoroquinolones) of patients. Bempedoic acid use was reported in 1556 (< 0.1%) patients. TRT prevalence during 12-month follow-up was 3.4% (ASCVD cohort) and 1.9% (overall population). Among patients with ASCVD, 83.5% experienced TRT in only one region of the body. Factors most associated with TRT in the ASCVD cohort were increasing age, most notably in those aged 45-64 years (odds ratio [OR] 2.19; 95% confidence interval [CI] 2.07-2.32), obesity (OR 1.51; 95% CI 1.50-1.53), and rheumatoid arthritis (OR 1.47; 95% CI 1.45-1.79). Use of statins or bempedoic acid was not associated with increased TRT risk.
Patients with ASCVD may have greater risk of TRT than the general population, which may be driven by an increased prevalence of comorbidities and use of medications with a potential or known association with TRT.
在大量动脉粥样硬化性心血管疾病（ASCVD）患者中，肌腱断裂和肌腱病（TRT）的患病率尚未确定。我们使用美国一个大型医疗和药房理赔数据库——Symphony Health综合数据集的数据，调查了ASCVD患者和普通人群中TRT的患病率。
这项回顾性观察性研究纳入了识别期（2019年1月至2020年12月）及连续登记12个月期间，来自理赔数据库中年龄≥19岁的患者。主要结局是索引日期（ASCVD队列中的首次ASCVD诊断；总体人群中理赔数据库中的首次理赔）后12个月内TRT的证据。使用诊断编码（ICD - 10和/或CPT）来定义ASCVD和TRT诊断。
ASCVD队列和总体人群分别包括5589273例和61715843例患者。在ASCVD队列中，分别有67.9%（他汀类药物）、17.7%（皮质类固醇）和16.7%（氟喹诺酮类）的患者使用了与TRT有潜在或已知关联的药物。1556例（<0.1%）患者报告使用了贝派地酸。12个月随访期间TRT的患病率在ASCVD队列中为3.4%，在总体人群中为1.9%。在ASCVD患者中，83.5%仅在身体的一个部位出现TRT。ASCVD队列中与TRT最相关的因素是年龄增长，尤其是45 - 64岁的患者（优势比[OR]2.19；95%置信区间[CI]2.07 - 2.32）、肥胖（OR 1.51；95% CI 1.50 - 1.53）和类风湿性关节炎（OR 1.47；95% CI 1.45 - 1.79）。使用他汀类药物或贝派地酸与TRT风险增加无关。
ASCVD患者发生TRT的风险可能高于普通人群，这可能是由合并症患病率增加以及使用与TRT有潜在或已知关联的药物所致。
