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J Clin Endocrinol Metab. 2018 Sep 1;103(9):3439-3448. doi: 10.1210/jc.2018-00652.

Statin Use Is Associated With Decreased Osteoporosis and Fracture Risks in Stroke Patients.

Author information

1
Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
2
Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
3
Department of Family Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.

Abstract

Context:

Poststroke osteoporosis and consequent fractures increase the risk of morbidity and mortality and cause considerable socioeconomic burden.

Objective:

To evaluate the association between statin use and risks of osteoporosis and fracture in stroke patients.

Design:

Population-based propensity score‒matched cohort study.

Setting:

Taiwan's National Health Insurance Research Database.

Patients:

Patients newly diagnosed with a stroke between 2000 and 2012 were identified. After propensity score matching, 5254 patients were included, with 2627 patients in the statin and nonstatin cohorts, respectively.

Main Outcome Measures:

Hazard ratios (HRs) for poststroke osteoporosis, hip fracture, and vertebral fracture (together, the primary outcome) were calculated using Cox proportional hazards regression models according to statin use status.

Results:

Poststroke statin use was associated with a lower overall risk of the primary outcome [adjusted hazard ratio (aHR) = 0.66; P < 0.001]. In subanalyses, statin use was associated with a decreased risk of all individual outcomes, including osteoporosis (aHR = 0.68; P < 0.001), hip fracture (aHR = 0.59; P < 0.001), and vertebral fracture (aHR = 0.73; P = 0.003). A dose-effect relationship was identified. The aHRs for developing the primary outcome were 0.96, 0.86, and 0.34 for patients who used 1 to 90, 91 to 365, and >365 cumulative defined daily doses of statins, respectively. These dose-effect relationships were maintained on subgroup analyses stratified by age, sex, and stroke type and sensitivity analyses conducted without propensity score matching.

Conclusions:

Statin use is associated with decreased risks of osteoporosis, hip fracture, and vertebral fracture in stroke patients.

PMID:
29982482
DOI:
10.1210/jc.2018-00652
[Indexed for MEDLINE]

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