ABSTRACT
Patients with ischemic heart disease (IHD) are more likely to be diagnosed with prostate cancer. Statins, which are widely used in such patients, are shown to modify the risk of prostate cancer. To clarify the association between statin use and the risk of prostate cancer among patients with higher risk of developing prostate cancer in Taiwan, a cohort of 26,628 men with IHD and aged between 55 and 100 were acquired from the National Health Insurance Research Database and followed over a period of 8 years. The risk of prostate cancer was calculated by time-dependent Cox regression model. Statin use was associated with significantly lower risk of both total and advanced prostate cancer (adjusted hazard ratio (HR): 0.719, 95% confidence interval (CI): 0.570-0.908; adjusted HR: 0.718, 95% CI: 0.530-0.972 respectively). In Taiwan IHD population, the reduction in risk of prostate cancer was observed in statin users as compared with nonusers.
Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors , Myocardial Ischemia , Prostatic Neoplasms , Aged , Aged, 80 and over , Cohort Studies , Correlation of Data , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/classification , Male , Middle Aged , Myocardial Ischemia/drug therapy , Myocardial Ischemia/epidemiology , National Health Programs/statistics & numerical data , Neoplasm Staging , Outcome Assessment, Health Care , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/pathology , Retrospective Studies , Risk Assessment , Taiwan/epidemiologyABSTRACT
BACKGROUND: The clinical benefits of a combination of statins and ezetimibe in patients with acute coronary syndrome (ACS) were observed in a clinical trial. However, little is known regarding the effectiveness of using statins with or without ezetimibe in patients with ACS and multiple comorbidities in real-world clinical practice. METHODS: This is a nationwide population-based cohort study using Taiwan National Health Insurance Research Database. A total of 212,110 patients with ACS who had been discharged after their first ACS events between 2006 and 2010 were enrolled. A propensity score matching approach was used to create matched cohorts for adjusting potential confounders. Cox proportional hazards regressions were performed to estimate the risk of re-hospitalization for ACS and revascularization. RESULTS: Patients in the statins-plus-ezetimibe group had a significantly lower risk of re-hospitalization for ACS (adjusted hazard ratio [HR]=0.64, 95% confidence interval [CI]: 0.60-0.69) and revascularization (HR=0.69, 95% CI: 0.63-0.76) than those in the statins-alone group. In the statins-plus-ezetimibe group, female patients had a lower risk of re-hospitalization for ACS than male patients did, and patients without diabetes mellitus had a lower risk of re-hospitalization for ACS than did patients with diabetes mellitus. CONCLUSIONS: Patients with ACS and multiple comorbidities receiving a combination therapy of statins and ezetimibe had a lower risk of re-hospitalization for ACS and revascularization than those receiving statins alone. Significant interaction effects were observed between combination with ezetimibe, sex, and diabetes mellitus.
