Statins cut death risk in atherosclerotic cardiovascular disease

The use of statins helps reduce all-cause mortality in patients with atherosclerotic cardiovascular disease (ASCVD), especially in the first 6 months after an event, reports a recent study.

Drawing from medical record and insurance claim databases, researchers assessed 8,168 adults who had survived an ASCVD hospitalization from September 2013 to September 2014. The primary outcome of interest was the occurrence major adverse cardiovascular events (MACE), stratified into fatal and nonfatal events. Deaths were also assessed.

Of the participants, 3,866 (47.33 percent) filled a prescription for statins ≤90 days before index ASCVD, while 4,152 (50.83 percent) did so after the episode. Post-ASCVD users were younger and had more comorbidities. During the study, a total of 686 patients (8.4 percent) experienced 763 MACE events, of which 41.3 percent was terminal.

Multivariable Cox analysis found that statin use significantly reduced the risk of MACE by 18 percent (hazard ratio [HR], 0.82, 95 percent confidence interval [CI], 0.70–0.95; p=0.007), an effect that was stronger during the first 180 days (HR, 0.72, 95 percent CI, 0.60–0.86; p<0.001).

A subsequent joint marginal model found that statins had a nonsignificant effect on nonfatal MACEs (rate ratio, 0.81, 95 percent CI, 0.49–1.32; p=0.394), but was significantly protective against all-cause deaths, cutting such risk by 65 percent (HR, 0.35, 95 percent CI, 0.22–0.56; p<0.001).

“When jointly modeling nonfatal and fatal events, we observed that the primary benefit of statin use was protection against early death,” the researchers said. “Furthermore, because we observed that statin use may have the greatest impact in the first 6 months after an ASCVD event, it is crucial for patients to quickly adhere to therapy.”