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Statin use and risk of haemorrhagic stroke in a community-based cohort of postmenopausal women: an observational study from the Women's Health Initiative

Salmoirago-Blotcher, Elena ; Hovey, Kathleen M ; Andrews, Christopher A ; Robinson, Jennifer G ; Johnson, Karen C ; Wassertheil-Smoller, Sylvia ; Crawford, Sybil ; Qi, Lihong ; Martin, Lisa W ; Ockene, Judith ; Manson, JoAnn E ; Nabel, Elizabeth ; Rossouw, Jacques ; Ludlam, Shari ; McGowan, Joan ; Ford, Leslie ; Geller, Nancy ; Prentice, Ross ; Anderson, Garnet ; LaCroix, Andrea ; Kooperberg, Charles L ; Patterson, Ruth E ; McTiernan, Anne ; Stein, Evan ; Cummings, Steven ; Rajkovic, Aleksandar ; Eaton, Charles B ; Phillips, Lawrence ; Beresford, Shirley ; Chlebowski, Rowan ; Michael, Yvonne ; Caan, Bette ; Kotchen, Jane Morley ; Howard, Barbara V ; Van Horn, Linda ; Black, Henry ; Stefanick, Marcia L ; Lane, Dorothy ; Jackson, Rebecca ; Lewis, Cora E ; Thomson, Cynthia A ; Wactawski-Wende, Jean ; Robbins, John ; Hubbell, F Allan ; Nathan, Lauren ; Langer, Robert D ; Gass, Margery ; Limacher, Marian ; Curb, J David ; Wallace, Robert ; Lasser, Norman ; O'Sullivan, Mary Jo ; Margolis, Karen ; Brunner, Robert ; Heiss, Gerardo ; Kuller, Lewis ; Brzyski, Robert ; Sarto, Gloria E ; Vitolins, Mara ; Simon, Michael ; Shumaker, Sally

BMJ Open, 2015-02, Vol.5 (2)

eScholarship, University of California

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Título:
Statin use and risk of haemorrhagic stroke in a community-based cohort of postmenopausal women: an observational study from the Women's Health Initiative
Autor: Salmoirago-Blotcher, Elena ; Hovey, Kathleen M ; Andrews, Christopher A ; Robinson, Jennifer G ; Johnson, Karen C ; Wassertheil-Smoller, Sylvia ; Crawford, Sybil ; Qi, Lihong ; Martin, Lisa W ; Ockene, Judith ; Manson, JoAnn E ; Nabel, Elizabeth ; Rossouw, Jacques ; Ludlam, Shari ; McGowan, Joan ; Ford, Leslie ; Geller, Nancy ; Prentice, Ross ; Anderson, Garnet ; LaCroix, Andrea ; Kooperberg, Charles L ; Patterson, Ruth E ; McTiernan, Anne ; Stein, Evan ; Cummings, Steven ; Rajkovic, Aleksandar ; Eaton, Charles B ; Phillips, Lawrence ; Beresford, Shirley ; Chlebowski, Rowan ; Michael, Yvonne ; Caan, Bette ; Kotchen, Jane Morley ; Howard, Barbara V ; Van Horn, Linda ; Black, Henry ; Stefanick, Marcia L ; Lane, Dorothy ; Jackson, Rebecca ; Lewis, Cora E ; Thomson, Cynthia A ; Wactawski-Wende, Jean ; Robbins, John ; Hubbell, F Allan ; Nathan, Lauren ; Langer, Robert D ; Gass, Margery ; Limacher, Marian ; Curb, J David ; Wallace, Robert ; Lasser, Norman ; O'Sullivan, Mary Jo ; Margolis, Karen ; Brunner, Robert ; Heiss, Gerardo ; Kuller, Lewis ; Brzyski, Robert ; Sarto, Gloria E ; Vitolins, Mara ; Simon, Michael ; Shumaker, Sally
Assuntos: Aging ; Biomedical and Clinical Sciences ; Clinical Research ; Clinical Sciences ; Female ; Follow-Up Studies ; Health Sciences ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Middle Aged ; Other Medical and Health Sciences ; Postmenopause ; Prevention ; PREVENTIVE MEDICINE ; Proportional Hazards Models ; Psychology ; Public Health ; Public Health and Health Services ; Retrospective Studies ; Risk Factors ; Stroke ; Women's Health
É parte de: BMJ Open, 2015-02, Vol.5 (2)
Notas: e007075
BMJ Open, vol 5, iss 2
Descrição: ObjectivesTo determine whether statin treatment is associated with increased risk of haemorrhagic stroke (HS) in older women. A secondary objective was to evaluate HS risk in users of combined statin and antiplatelet treatment.DesignObservational study: secondary data analysis from the Women's Health Initiative (WHI) clinical trials.SettingWomen were recruited from 40 participating sites.ParticipantsCohort of 68,132 women followed through 2005 (parent study) and for an additional 5 years in the extension study.Main outcome measuresStatin use was assessed at baseline and at follow-up visits (1, 3, 6 and 9 years). Women brought medications in original containers for inventory. Strokes were ascertained semiannually and centrally adjudicated. Risk of HS by statin use (time-varying covariate, with the 'no use' category as the referent) was estimated from Cox proportional hazard regression models adjusted for age (model 1); risk factors for HS (model 2); and possible confounders by indication (model 3). Prespecified subgroup analyses were conducted by use of antiplatelet medications.ResultsFinal models included 67,882 women (mean age, 63±7 years). Over a mean follow-up of 12 years, incidence rates of HS were 6.4/10,000 person-years among statin users and 5.0/10,000 person-years among non-users (p=0.11). The unadjusted risk of HS in statin users was 1.21 (CI 0.96 to 1.53); after adjusting for age and HS risk factors the HR was 0.98 (CI 0.76 to 1.26). Risk of HS was higher among women on statins and antiplatelet agents versus women on antiplatelet medications alone (HR=1.59; CI 1.03 to 2.47); p for interaction=0.011.ConclusionsThis retrospective analysis did not show an association between statin use and HS risk among older women. HS risk was higher among women taking statins with antiplatelet agents. These findings warrant further investigation, given potential implications for clinical decision-making.
Editor: eScholarship, University of California
Idioma: Inglês

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Statin use and risk of haemorrhagic stroke in a community-based cohort of postmenopausal women: an observational study from the Women's Health Initiative

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