Verček Gregor, Furlan Tjaša, Gavrić Dalibor, Lainščak Mitja, Farkaš Lainščak Jerneja, Ograjenšek Irena, Došenović Bonča Petra, Jug Borut
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Int J Cardiol Cardiovasc Risk Prev. 2025 Apr 25;25:200415. doi: 10.1016/j.ijcrp.2025.200415. eCollection 2025 Jun.
Statin therapy is recommended for secondary prevention of atherosclerotic vascular disease (ASCVD) based on randomized trials, which enrolled mostly men with coronary artery disease (CAD), whereas women and patients with cerebrovascular (CVD) and peripheral artery disease (PAD) were under-represented. We analyzed the effectiveness of statin therapy uptake in a nation-wide cohort of women hospitalized for ASCVD.
Women hospitalized for CAD, CVD, or PAD, including aortic disease, between 2015 and 2021 were retrospectively identified by linking the national hospital database, medicines reimbursement claims, and national mortality registry. The association of statin uptake within 30 days post-discharge with clinical outcomes (all-cause mortality and cardiovascular hospitalizations) was assessed by Kaplan-Meier curves and Cox proportional hazards regression model with propensity score-derived inverse probability of treatment weights and a 30-day landmark period.
We included 24,665 women with ASCVD - 14,419 with CAD, 5,427 with CVD, and 4,819 with PAD. Overall, the median age was 73 (64-81) years. The rates of statin uptake were 50 % for women with CAD, 60 % for CVD and 28 % for PAD. Statin therapy uptake was associated with a reduction in all-cause mortality and cardiovascular hospitalizations across all three major types of ASCVD: hazard ratio (HR) 0.88, 95 % confidence interval (CI) 0.83-0.93, p = 0.001 for CAD, HR 0.87, 95 % CI 0.80-0.94, p = 0.006 for PAD, and HR 0.72, 95 % CI 0.66-0.78, p < 0.001 for CVD.
Statin therapy is associated with reduced all-cause mortality and cardiovascular hospital readmissions in women with all major types of ASCVD.
基于随机试验，他汀类药物疗法被推荐用于动脉粥样硬化性血管疾病（ASCVD）的二级预防，这些试验的受试者大多为患有冠状动脉疾病（CAD）的男性，而女性以及患有脑血管疾病（CVD）和外周动脉疾病（PAD）的患者代表性不足。我们分析了在全国范围内因ASCVD住院的女性队列中他汀类药物疗法的有效性。
通过关联国家医院数据库、药品报销申请和国家死亡率登记册，对2015年至2021年间因CAD、CVD或PAD（包括主动脉疾病）住院的女性进行回顾性识别。通过Kaplan-Meier曲线和Cox比例风险回归模型，采用倾向评分推导的治疗权重逆概率和30天的标志性时间段，评估出院后30天内他汀类药物的使用与临床结局（全因死亡率和心血管疾病住院）之间的关联。
我们纳入了24665名患有ASCVD的女性——14419名患有CAD，5427名患有CVD，4819名患有PAD。总体而言，中位年龄为73（64-81）岁。CAD女性的他汀类药物使用率为50%，CVD女性为60%，PAD女性为28%。在所有三种主要类型的ASCVD中，他汀类药物疗法的使用与全因死亡率和心血管疾病住院率的降低相关：CAD的风险比（HR）为0.88，95%置信区间（CI）为0.83-0.93，p = 0.001；PAD的HR为0.87，95%CI为0.80-0.94，p = 0.006；CVD的HR为0.72，95%CI为0.66-0.78，p < 0.001。
他汀类药物疗法与所有主要类型ASCVD女性的全因死亡率降低和心血管疾病再次住院率降低相关。
