Statin adherence and risk of accidents: a cautionary tale.

Abstract:

BACKGROUND:Bias in studies of preventive medications can occur when healthier patients are more likely to initiate and adhere to therapy than less healthy patients. We sought evidence of this bias by examining associations between statin exposure and various outcomes that should not be causally affected by statin exposure, such as workplace and motor vehicle accidents. METHODS AND RESULTS:We conducted a prospective cohort study of statin patients using data from British Columbia, Canada, a multiethnic society with a population of 4.3 million people. Study subjects were 141 086 patients who initiated statins for primary prevention. We examined the association between adherence and multiple outcomes such as accidents and screening procedures using multivariable-adjusted Cox proportional hazards models. The study population was 49% female and had an average age of 61 years. The results from our multivariable-adjusted models showed that more adherent patients were less likely to have accidents than less adherent patients. This effect was greatest for motor vehicle accidents (hazard ratio, 0.75; 95% confidence interval, 0.72 to 0.79) and workplace accidents (hazard ratio, 0.77; 95% confidence interval, 0.74 to 0.81). More adherent patients had a greater likelihood of using screening services (hazard ratio, 1.17; 95% confidence interval, 1.15 to 1.20) and a lower likelihood of developing other diseases likely to be unrelated to a biological affect of a statin (hazard ratio, 0.87; 95% confidence interval, 0.86 to 0.89). CONCLUSIONS:Our study contributes compelling evidence that patients who adhere to statins are systematically more health seeking than comparable patients who do not remain adherent. Caution is warranted when interpreting analyses that attribute surprising protective effects to preventive medications.

journal_name

Circulation

journal_title

Circulation

authors

Dormuth CR,Patrick AR,Shrank WH,Wright JM,Glynn RJ,Sutherland J,Brookhart MA

doi

10.1161/CIRCULATIONAHA.108.824151

subject

Has Abstract

pub_date

2009-04-21 00:00:00

pages

2051-7

issue

15

eissn

0009-7322

issn

1524-4539

pii

CIRCULATIONAHA.108.824151

journal_volume

119

pub_type

杂志文章
  • Congenital abnormalities of the conduction system in two patients with tachyarrhythmias.

    abstract::Serial sections of the conduction system (CS) were performed in two patients with recurrent tachyarrhythmias. Case 1, a 34-year-old female who had dual atrioventricular (AV) nodal pathways with recurrent paroxysmal supraventricular tachycardia, committed suicide. Autopsy revealed an abnormally formed atrial septum wit...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.59.3.593

    authors: Bharati S,Bauernfiend R,Scheinman M,Massie B,Cheitlin M,Denes P,Wu D,Lev M,Rosen KM

    更新日期:1979-03-01 00:00:00

  • Lysophosphatidylcholine and reactive oxygen species mediate the synergistic effect of mildly oxidized LDL with serotonin on vascular smooth muscle cell proliferation.

    abstract:BACKGROUND:Mild oxidation of LDL enhances its atherogenic potential and induces a synergistic interaction with serotonin (5HT) on vascular smooth muscle cell (VSMC) proliferation. Because of its complex chemical nature, the mitogenic components of mildly oxidized LDL (moxLDL) remain unclear. METHODS AND RESULTS:We exa...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.103.10.1440

    authors: Watanabe T,Pakala R,Koba S,Katagiri T,Benedict CR

    更新日期:2001-03-13 00:00:00

  • Index matching to improve optical coherence tomography imaging through blood.

    abstract:BACKGROUND:Most myocardial infarctions are caused by the rupture of small rather than large plaques in the arteries of the heart that are beyond the detection limit of current technologies. METHODS AND RESULTS:Recently, optical coherence tomography (OCT) has demonstrated considerable potential as a method for high-res...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.103.15.1999

    authors: Brezinski M,Saunders K,Jesser C,Li X,Fujimoto J

    更新日期:2001-04-17 00:00:00

  • Characterization of human atherosclerotic plaques by intravascular magnetic resonance imaging.

    abstract:BACKGROUND:Development and validation of novel imaging modalities to assess the composition of human atherosclerotic plaques will improve the understanding of atheroma evolution and could facilitate evaluation of therapeutic strategies for plaque modification. Surface MRI can characterize tissue content of carotid but ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.105.538942

    authors: Larose E,Yeghiazarians Y,Libby P,Yucel EK,Aikawa M,Kacher DF,Aikawa E,Kinlay S,Schoen FJ,Selwyn AP,Ganz P

    更新日期:2005-10-11 00:00:00

  • Effects of aging and cardiac denervation on heart rate variability during sleep.

    abstract:BACKGROUND:Cardiac vagal predominance increases the RR interval and RR high-frequency (HF) variability during non-rapid eye movement (non-REM) sleep (stages I through IV) in young subjects. Aging suppresses deep sleep, but effects of age-related changes in sleep architecture on RR are unknown. Whether mechanical effect...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.103.1.84

    authors: Crasset V,Mezzetti S,Antoine M,Linkowski P,Degaute JP,van de Borne P

    更新日期:2001-01-02 00:00:00

  • Multiple Arterial Grafting Is Associated With Better Outcomes for Coronary Artery Bypass Grafting Patients.

    abstract:BACKGROUND:Observational studies have shown better survival in patients undergoing coronary artery bypass grafting (CABG) with 2 arterial grafts compared with 1. However, whether a third arterial graft is associated with incremental benefit remains uncertain. We sought to analyze the outcomes of 3 versus 2 arterial gra...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/CIRCULATIONAHA.118.034464

    authors: Rocha RV,Tam DY,Karkhanis R,Nedadur R,Fang J,Tu JV,Gaudino M,Royse A,Fremes SE

    更新日期:2018-11-06 00:00:00

  • Emergency polytetrafluoroethylene-covered stent implantation to treat coronary ruptures.

    abstract:BACKGROUND:Coronary perforation is a life-threatening complication of percutaneous interventions. In the past few years, the implantation of covered stents has emerged as a strategy for treatment when the traditional conservative approach (ie, prolonged balloon inflation and reversal of anticoagulation) fails. METHODS...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.102.25.3028

    authors: Briguori C,Nishida T,Anzuini A,Di Mario C,Grube E,Colombo A

    更新日期:2000-12-19 00:00:00

  • Serial electrophysiologic testing of multiple drugs in patients with atrioventricular nodal reentrant paroxysmal tachycardia.

    abstract::Serial electrophysiologic testing of multiple drugs was performed in 21 patients with recurrent atrioventricular (AV) nodal reentrant paroxysmal supraventricular tachycardia (PSVT). All patients had reproducible sustained PSVT induced before drug administration. Serial daily PSVT induction was attempted after administ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.62.6.1341

    authors: Bauernfeind RA,Wyndham CR,Dhingra RC,Swiryn SP,Palileo E,Strasberg B,Rosen KM

    更新日期:1980-12-01 00:00:00

  • Assessment of myocardial ischemia with proton magnetic resonance: effects of a three hour coronary occlusion with and without reperfusion.

    abstract::Proton (hydrogen-1) magnetic resonance imaging techniques have potential for the detection and characterization of changes associated with myocardial ischemia. Since image contrast is dependent on T1 and T2 relaxation times, we examined these parameters in a canine preparation of occlusion of the left anterior descend...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.71.3.595

    authors: Johnston DL,Brady TJ,Ratner AV,Rosen BR,Newell JB,Pohost GM,Okada RD

    更新日期:1985-03-01 00:00:00

  • Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    abstract::The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients a...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIR.0000000000000380

    authors: Rich MW,Chyun DA,Skolnick AH,Alexander KP,Forman DE,Kitzman DW,Maurer MS,McClurken JB,Resnick BM,Shen WK,Tirschwell DL,American Heart Association Older Populations Committee of the Council on Clinical Cardiology, Council on Cardiov

    更新日期:2016-05-24 00:00:00

  • Clinical outcomes after ablation and pacing therapy for atrial fibrillation : a meta-analysis.

    abstract:BACKGROUND:Radiofrequency ablation of the atrioventricular node and permanent pacing are used for symptomatic relief in patients with medically refractory atrial fibrillation. In this study, meta-analysis was used to clarify clinical outcomes and survival after ablation and pacing therapy using data from the published ...

    journal_title:Circulation

    pub_type: 杂志文章,meta分析

    doi:10.1161/01.cir.101.10.1138

    authors: Wood MA,Brown-Mahoney C,Kay GN,Ellenbogen KA

    更新日期:2000-03-14 00:00:00

  • Inherited arrhythmias: a National Heart, Lung, and Blood Institute and Office of Rare Diseases workshop consensus report about the diagnosis, phenotyping, molecular mechanisms, and therapeutic approaches for primary cardiomyopathies of gene mutations affe

    abstract::The National Heart, Lung, and Blood Institute and Office of Rare Diseases at the National Institutes of Health organized a workshop (September 14 to 15, 2006, in Bethesda, Md) to advise on new research directions needed for improved identification and treatment of rare inherited arrhythmias. These included the followi...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.107.711689

    authors: Lehnart SE,Ackerman MJ,Benson DW Jr,Brugada R,Clancy CE,Donahue JK,George AL Jr,Grant AO,Groft SC,January CT,Lathrop DA,Lederer WJ,Makielski JC,Mohler PJ,Moss A,Nerbonne JM,Olson TM,Przywara DA,Towbin JA,Wang LH,M

    更新日期:2007-11-13 00:00:00

  • Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction.

    abstract:BACKGROUND:Brain natriuretic peptide is a novel natriuretic peptide that is secreted predominantly from the ventricles, and its plasma levels have been shown to be markedly increased in patients with chronic congestive heart failure. This study was designed to examine the plasma levels of brain natriuretic peptide as w...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.88.1.82

    authors: Morita E,Yasue H,Yoshimura M,Ogawa H,Jougasaki M,Matsumura T,Mukoyama M,Nakao K

    更新日期:1993-07-01 00:00:00

  • Pulmonary regurgitation in the late postoperative follow-up of tetralogy of Fallot. Volumetric quantitation by nuclear magnetic resonance velocity mapping.

    abstract:BACKGROUND:Pulmonary regurgitation frequently occurs after surgical correction of tetralogy of Fallot. To date, reliable quantitation of pulmonary regurgitation has not been possible, and therefore the clinical significance of pulmonary regurgitation is controversial. Nuclear magnetic resonance (NMR) velocity mapping a...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.88.5.2257

    authors: Rebergen SA,Chin JG,Ottenkamp J,van der Wall EE,de Roos A

    更新日期:1993-11-01 00:00:00

  • Total anomalous pulmonary venous connection and severe pulmonic stenosis in a 52-year-old man.

    abstract::Total anomalous pulmonary venous connection (TAPVC) is a rare cardiac congenital abnormality which usually results in death in infancy or early childhood. We describe a 52-year-old man with TAPVC and severe calcific pulmonic stenosis. Both diagnoses were suspected clinically and from the chest X-ray. Cardiac catheteri...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.55.1.206

    authors: Pastore JO,Akins CW,Zir LM,Buckley MJ,Dinsmore RE

    更新日期:1977-01-01 00:00:00

  • Exercise testing in children before and after surgical treatment of aortic stenosis.

    abstract::Twenty-three children with valvar or discrete subvalvar aortic stenosis underwent a controlled, progressive bicycle exercise test within 6 months before and 3-30 months after surgery for left ventricular outflow tract obstruction. The patients were divided into three groups according to the preoperative resting gradie...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.63.2.254

    authors: Whitmer JT,James FW,Kaplan S,Schwartz DC,Knight MJ

    更新日期:1981-02-01 00:00:00

  • Right Ventricular Fibrosis.

    abstract::The role of right ventricular (RV) fibrosis in pulmonary hypertension (PH) remains a subject of ongoing discussion. Alterations of the collagen network of the extracellular matrix may help prevent ventricular dilatation in the pressure-overloaded RV. At the same time, fibrosis impairs cardiac function, and a growing b...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.118.035326

    authors: Andersen S,Nielsen-Kudsk JE,Vonk Noordegraaf A,de Man FS

    更新日期:2019-01-08 00:00:00

  • Early results of a simplified method of mitral valve annuloplasty.

    abstract:BACKGROUND:We hypothesized that a simple, unmeasured posterior annuloplasty technique (two thirds of a 27-mm Duran ring) offered advantages of standardization and ease of insertion. METHODS AND RESULTS:A consecutive series of all patients (n = 418; median age, 67 years) having mitral valve repair performed by two surg...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.92.9.150

    authors: Odell JA,Schaff HV,Orszulak TA

    更新日期:1995-11-01 00:00:00

  • Continuous rapid atrial pacing to control recurrent or sustained supraventricular tachycardias following open heart surgery.

    abstract::A technique is described to control recurrent or sustained supraventricular tachycardia associated with rapid ventricular rates following open heart surgery. The technique utilizes a pair of temporarily implanted atrial epicardial wire electrodes to pace the heart. In one group of patients with recurrent atrial flutte...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.54.2.245

    authors: Waldo AL,MacLean WA,Karp RB,Kouchoukos NT,James TN

    更新日期:1976-08-01 00:00:00

  • Cyclooxygenase-2 inhibitor treatment improves left ventricular function and mortality in a murine model of doxorubicin-induced heart failure.

    abstract:BACKGROUND:Progression of heart failure after initial myocardial injury is mediated in part by various redundant inflammatory mediators, including the widely expressed cyclooxygenase-2 (COX-2). Because COX-2 inhibitors are useful in treating many inflammation-mediated diseases, we asked whether COX-2 inhibition can att...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000121354.34067.48

    authors: Delgado RM 3rd,Nawar MA,Zewail AM,Kar B,Vaughn WK,Wu KK,Aleksic N,Sivasubramanian N,McKay K,Mann DL,Willerson JT

    更新日期:2004-03-23 00:00:00

  • Alteration in left ventricular diastolic filling and accumulation of myocardial collagen at insulin-resistant prediabetic stage of a type II diabetic rat model.

    abstract:BACKGROUND:Considerable controversy exists regarding impairment of cardiac function in diabetes mellitus (DM). We investigated the serial changes in left ventricular (LV) histopathology and LV filling dynamics in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, which have been established as an animal model of type II D...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.101.8.899

    authors: Mizushige K,Yao L,Noma T,Kiyomoto H,Yu Y,Hosomi N,Ohmori K,Matsuo H

    更新日期:2000-02-29 00:00:00

  • Enhanced activity of variant phospholipase C-delta1 protein (R257H) detected in patients with coronary artery spasm.

    abstract:BACKGROUND:We recently demonstrated that phospholipase C (PLC)-delta1 activity in cultured skin fibroblasts obtained from patients with coronary spastic angina (CSA) is enhanced. We tested the hypothesis that structural abnormality in PLC-delta1 isoform is a cause of the enhanced activity. METHODS AND RESULTS:Sequence...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000014613.36469.3f

    authors: Nakano T,Osanai T,Tomita H,Sekimata M,Homma Y,Okumura K

    更新日期:2002-04-30 00:00:00

  • Availability and Use of Shared Data From Cardiometabolic Clinical Trials.

    abstract:BACKGROUND:Sharing of patient-level clinical trial data has been widely endorsed. Little is known about how extensively these data have been used for cardiometabolic diseases. We sought to evaluate the availability and use of shared data from cardiometabolic clinical trials. METHODS:We extracted data from ClinicalStud...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.117.031883

    authors: Vaduganathan M,Nagarur A,Qamar A,Patel RB,Navar AM,Peterson ED,Bhatt DL,Fonarow GC,Yancy CW,Butler J

    更新日期:2018-02-27 00:00:00

  • View-synchronized robotic image-guided therapy for atrial fibrillation ablation: experimental validation and clinical feasibility.

    abstract:BACKGROUND:A robotic catheter navigation system has been developed that provides a significant degree of freedom of catheter movement. This study examines the feasibility of synchronizing this robotic navigation system with electroanatomic mapping and 3-dimensional computed tomography imaging to perform view-synchroniz...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/CIRCULATIONAHA.106.677369

    authors: Reddy VY,Neuzil P,Malchano ZJ,Vijaykumar R,Cury R,Abbara S,Weichet J,McPherson CD,Ruskin JN

    更新日期:2007-05-29 00:00:00

  • Effects of diastolic transseptal pressure gradient on ventricular septal position and motion.

    abstract::Despite the clinical prevalence of paradoxic interventricular septal (IVS) motion, its pathogenesis remains unclear. To assess the influence of the end-diastolic transseptal pressure gradient, we studied eight open-chest dogs during right ventricular (RV) volume loading (induced by opening a Dacron shunt between the p...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.68.6.1304

    authors: Kingma I,Tyberg JV,Smith ER

    更新日期:1983-12-01 00:00:00

  • Cardiac interbeat interval dynamics from childhood to senescence : comparison of conventional and new measures based on fractals and chaos theory.

    abstract:BACKGROUND:New methods of R-R interval variability based on fractal scaling and nonlinear dynamics ("chaos theory") may give new insights into heart rate dynamics. The aims of this study were to (1) systematically characterize and quantify the effects of aging from early childhood to advanced age on 24-hour heart rate ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.100.4.393

    authors: Pikkujämsä SM,Mäkikallio TH,Sourander LB,Räihä IJ,Puukka P,Skyttä J,Peng CK,Goldberger AL,Huikuri HV

    更新日期:1999-07-27 00:00:00

  • Low hepatic lipase activity is a novel risk factor for coronary artery disease.

    abstract:BACKGROUND:The crucial function of hepatic lipase (HL) in lipid metabolism has been well established, but the relationship between HL activity and coronary artery disease (CAD) is disputed. METHODS AND RESULTS:We measured HL activity in the postheparin plasma of 200 consecutive men undergoing elective coronary angiogr...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/hc5001.100795

    authors: Dugi KA,Brandauer K,Schmidt N,Nau B,Schneider JG,Mentz S,Keiper T,Schaefer JR,Meissner C,Kather H,Bahner ML,Fiehn W,Kreuzer J

    更新日期:2001-12-18 00:00:00

  • Diabetic cardiomyopathy revisited.

    abstract::Diabetes mellitus increases the risk of heart failure independently of underlying coronary artery disease, and many believe that diabetes leads to cardiomyopathy. The underlying pathogenesis is partially understood. Several factors may contribute to the development of cardiac dysfunction in the absence of coronary art...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:10.1161/CIRCULATIONAHA.106.679597

    authors: Boudina S,Abel ED

    更新日期:2007-06-26 00:00:00

  • Continuous-wave Doppler echocardiographic assessment of severity of calcific aortic stenosis: a simultaneous Doppler-catheter correlative study in 100 adult patients.

    abstract::Studies of the correlation of aortic valve gradient determined by continuous-wave Doppler echocardiography and that determined at catheterization have, to date, involved young patients and nonsimultaneous measurements. We therefore obtained simultaneous Doppler echocardiographic and catheter measurements of pressure g...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.71.6.1162

    authors: Currie PJ,Seward JB,Reeder GS,Vlietstra RE,Bresnahan DR,Bresnahan JF,Smith HC,Hagler DJ,Tajik AJ

    更新日期:1985-06-01 00:00:00

  • Flavone-8-acetic acid (Flavonoid) profoundly reduces platelet-dependent thrombosis and vasoconstriction after deep arterial injury In vivo.

    abstract:BACKGROUND:Flavone-8-acetic acid (FAA; [Flavonoid]), an adjuvant antitumor drug, inhibits ristocetin-induced aggregation of human platelets. The effect of FAA on platelet-dependent thrombosis was studied in vivo in the porcine carotid artery after deep arterial injury by balloon angioplasty. METHODS AND RESULTS:(111)I...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.101.3.324

    authors: Mruk JS,Webster MW,Heras M,Reid JM,Grill DE,Chesebro JH

    更新日期:2000-01-25 00:00:00