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- Title
Statins Reduce Bleeding Risk in Patients Taking Oral Anticoagulants for Nonvalvular Atrial Fibrillation: A Retrospective Registry Study.
- Authors
Uchida, Kazutaka; Ueda, Shinichiro; Sakakibara, Fumihiro; Kinjo, Norito; Nezu, Mari; Arai, Hideki; Morimoto, Takeshi
- Abstract
Background: The effects of statins in patients with non-valvular atrial fibrillation (NVAF) taking oral anticoagulants (OACs) are not well-studied. This study was a historical multicenter registry of patients with NVAF taking OACs in Japan. Methods: We excluded those patients with mechanical heart valves or a history of pulmonary or deep vein thrombosis. Overall, 7826 patients were registered on 26 February 2013 and followed until 25 February 2017. We compared those with versus without statin treatment (statin vs. no-statin groups) for the primary outcome of major bleeding and secondary outcomes of all-cause mortality, ischemic events, hemorrhagic stroke, and ischemic stroke. Results: Statins were administered in 2599 (33%) patients. The statin group was more likely to have paroxysmal AF (37% vs. 33%; p = 0.0003), hypertension (84% vs. 76%; p < 0.0001), diabetes mellitus (41% vs. 27%; p < 0.0001), and dyslipidemia (91% vs. 30%; p < 0.0001) than the no-statin group. The cumulative incidence of major bleeding was 6.9% and 8.1% (p = 0.06). The adjusted hazard ratio [HR] (95% confidence interval [CI]) of the statin group for major bleeding was 0.77 (0.63–0.94) compared with the no-statin group. The adjusted HR (95% CI) for all-cause mortality, ischemic events, hemorrhagic stroke, and ischemic stroke were 0.58 (0.47–0.71), 0.77 (0.59–0.999), 0.85 (0.48–1.50), and 0.79 (0.60–1.05), respectively. Conclusions: Statins significantly reduced the risk of major bleeding, all-cause mortality, and ischemic events in patients with NVAF taking OACs. Their additive benefits should be considered in routine practice and thus be further researched.
- Subjects
JAPAN; HEMORRHAGE prevention; STATINS (Cardiovascular agents); RESEARCH; CAUSES of death; HEMORRHAGIC stroke; CONFIDENCE intervals; ORAL drug administration; ISCHEMIC stroke; ATRIAL fibrillation; ANTICOAGULANTS; RETROSPECTIVE studies; TREATMENT effectiveness; RESEARCH funding; DESCRIPTIVE statistics; DATA analysis software
- Publication
American Journal of Cardiovascular Drugs, 2023, Vol 23, Issue 1, p89
- ISSN
1175-3277
- Publication type
Article
- DOI
10.1007/s40256-022-00555-4