Psychologic Disorders and Statin Use: A Propensity Score‐Matched Analysis

Mansi, Ishak A.; Frei, Christopher R.; Pugh, Mary Jo; Mortensen, Eric M.

doi:10.1002/phar.1272

Cited by 36 publications

(31 citation statements)

References 40 publications

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“…15 The method of creation and validation of AHRQ-CCS was previously published. [19][20][21][22][23] AHRQ-CCS disease categories have been widely used in numerous publications to identify comorbidities and outcomes, [24][25][26][27][28][29] predict mortality, 30,31 and estimate utilization and costs. [32][33][34][35] AHRQ-CCS disease categories are recognized by the Department of Defense Military Health System and are incorporated into Tricare data as an industry standard.…”

Section: Discussionmentioning

confidence: 99%

Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

et al. 2015

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BACKGROUND: Statin use is associated with increased incidence of diabetes and possibly with increased body weight and reduced exercise capacity. Data on the longterm effects of these associations in healthy adults, however, are very limited. In addition, the relationship between these effects and diabetic complications has not been adequately studied. OBJECTIVE: To examine the association between statin use and new-onset diabetes, diabetic complications, and overweight/obesity in a cohort of healthy adults. RESEARCH DESIGN: This was a retrospective cohort study. PARTICIPANTS: Subjects were Tricare beneficiaries who were evaluated between October 1, 2003 and March 1, 2012. Patients were divided into statin users and nonusers. INTERVENTION: We excluded patients who, at baseline, had a preexisting disease indicative of cardiovascular diseases, any positive element of the Charlson comorbidity index (including diabetes mellitus), or life-limiting chronic diseases. Using 42 baseline characteristics, we generated a propensity score to match statin users and nonusers. MAIN MEASURES: Outcomes assessed included newonset diabetes, diabetic complications, and overweight/ obesity. KEY RESULTS: A total of 25,970 patients (3982 statin users and 21,988 nonusers) were identified as healthy adults at baseline. Of these, 3351 statins users and 3351 nonusers were propensity score-matched. Statin users had higher odds of new-onset diabetes (odds ratio [OR] 1.87; 95 % confidence interval [95 % CI] 1.67-2.01), diabetes with complications (OR 2.50; 95 % CI 1.88-3.32), and overweight/obesity (OR 1.14; 95 % CI 1.04-1.25). Secondary and sensitivity analyses demonstrated similar findings. CONCLUSIONS: Diabetes, diabetic complications, and overweight/obesity were more commonly diagnosed among statin-users than similar nonusers in a healthy cohort of adults. This study demonstrates that short-term clinical trials might not fully describe the risk/benefit of long-term statin use for primary prevention.

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Section: Discussionmentioning

confidence: 99%

Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

et al. 2015

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“…We used prespecified outcome diagnosis groups to define psychological diseases as described in a previous publication. 6 Briefly, these outcomes were (1) schizophrenia and other psychosis: including codes for schizophrenia, schizoaffective disorders, and other psychosis as identified in the Veterans Aging Cohort Study 9 ; (2) depression and bipolar disorder: including codes for major depression, bipolar disorders, and post-traumatic stress disorder as identified in Veterans Aging Cohort Study; (3) all psychological diseases and disorders: consisting of all ICD-9 codes for psychological diseases as identified by AHRQ-CCS, 7 except for categories of childhood or developmental psychiatric Patients' baseline characteristics are described using the Charlson comorbidity index described by Deyo et al, 10 social habits, presence of psychological diseases at baseline, and other comorbid conditions and medication use as in shown in Table 1. 11 Baseline characteristics were compared using chisquare and Student t tests as appropriate. Comparisons were considered statistically significant if the calculated 2-tailed p value was 0.05.…”

Section: Methodsmentioning

confidence: 99%

“…All inpatient and outpatient medical encounters, diagnoses, and medication fill histories were retrieved using the Military Health System Management Analysis and Reporting Tool (M2), 5 as previously published. 6 The study was divided into 2 periods: baseline period (October 1,2003 7 and previous publications. 8 AHRQ-CCS is a diagnosis and procedure categorization scheme that can be used in analyzing data on diagnoses and procedures using ICD-9-CM codes.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Risk of Psychological and Cognitive Disorders Between Persistent and Nonpersistent Statin Users

Lilly

Mortensen

Frei

et al. 2014

The American Journal of Cardiology

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Despite their cardiovascular benefits, statin use has been associated with a wide array of actual or perceived psychological and cognitive adverse events. The objective of this study was to compare baseline characteristics and the risk of developing psychological and cognitive disorders between persistent and nonpersistent statin users. We performed a retrospective cohort study (October 1, 2003, to March 1, 2010 of 13,626 statin users in a regional US military health-care system. The persistence of statin use was defined by cumulative pharmacy fill data. Outcomes were the occurrence of psychological diseases during follow-up using prespecified groups based on International Classification of Diseases, Ninth Revision, codes: (1) schizophrenia and psychosis, (2) major depression and bipolar disorders, (3) all psychological diseases, and (4) dementia and cognitive disorders. Statin users who were nonpersistent at 2 years were younger, less likely to be men, and had fewer co-morbidities than persistent users. They were also more likely to be diagnosed with schizophrenia or psychosis (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.20 to 2.10) and cognitive disorders (OR 1.56, 95% CI 1.19 to 2.03) during follow-up compared with persistent users. There was not an association between nonpersistence at 2 years and the development of depression and bipolar disorders (OR 0.99, 95% CI 0.85 to 1.15) or combined psychological diseases (OR 0.97, 95% CI 0.86 to 1.09). Cumulative persistence with statin therapy as a continuous measure was associated with less risk of all outcomes. In conclusion, persistent statin users did not demonstrate an increase in the diagnosis of psychological disorders compared with nonpersistent users. Nonpersistent statin use was associated with a greater likelihood of being diagnosed with psychotic or cognitive disorders. Published by Elsevier Inc. (Am J Cardiol 2014;114:1035e1039) Several conflicting reports have examined the association of statins (hydroxymethylglutaryl coenzyme-A reductase inhibitors) and the risk of psychological and cognitive disorders. 1e4 Beyond the issue of whether statin use is associated with psychological side effects, the relation between persistence with statin therapy and the development of these disorders is unclear. Understanding such a relation, if one exists, is important for both providers and patients to improve guideline-based adherence to statin therapy. To our knowledge, no cohort or randomized controlled study has compared the prevalence of psychological disorders in statin users based on patient persistence with therapy.

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“…The database and study population have been described elsewhere. 8 Briefly, the extracted data included outpatient medical records, inpatient medical records, administrative data of services offered outside military facilities, and pharmacy data. Outpatient medical records and inpatient medical records contain all medical services activities, diagnosis codes, and procedure codes.…”

Section: Methodsmentioning

confidence: 99%

Frequency of Development of Connective Tissue Disease in Statin-Users Versus Nonusers

Schmidt

Battafarano

Mortensen

et al. 2013

The American Journal of Cardiology

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Psychologic Disorders and Statin Use: A Propensity Score‐Matched Analysis

Cited by 36 publications

References 40 publications

Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults

Comparison of the Risk of Psychological and Cognitive Disorders Between Persistent and Nonpersistent Statin Users

Frequency of Development of Connective Tissue Disease in Statin-Users Versus Nonusers

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