Continued statin therapy after adverse reaction reduces incidence of CV events, death
Continuation of statin prescriptions even after having an adverse reaction is associated with a lower incidence of mortality and cardiovascular (CV) events, a recent study has found.
Researchers recruited patients (n=28,266) with a presumed adverse reaction to a statin between 2000 and 2011 in a retrospective cohort study to explore the relationship between continued statin therapy (any prescription within 12 months after an adverse reaction) and clinical outcomes.
Information on adverse reactions to statins was obtained from structured electronic medical record data or natural-language processing of narrative provider notes. Time to a CV event (myocardial infarction or stroke) or death was the primary composite outcome.
The text of electronic provider notes provided most of the adverse reactions to statins (81 percent). Of the patients, 19,989 (70.7 percent) continued receiving statin prescriptions after the adverse reaction.
The cumulative incidence of CV events or death was 12.2 percent for patients with continued statin prescriptions vs 13.9 percent for those who stopped receiving statins (difference, 1.7 percent; 95 percent CI, 0.8 to 2.7 percent; p<0.001) 4 years after the presumed adverse event.
Secondary analysis of 7,604 patients who received a different statin after the adverse reaction revealed that 2,014 (26.5 percent) had a documented adverse reaction to the second statin. However, 1,696 (84.2 percent) of these patients continued to receive statin prescriptions.
“The risk of recurrent adverse reactions to statins could not be established for the entire sample,” researchers said, adding that it was also not possible to determine whether patients actually took the statins.