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Long-Term Outcomes of Short-Term Statin Use in Healthy Adults: A Retrospective Cohort Study

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Abstract

Introduction

Data suggest that the beneficial cardiovascular effects of statins are maximized after the first year of statin use; yet, the timeline of statin-associated adverse events is not well delineated.

Objective

To examine the associations of short-term statin use (≤1 year) with short- and long-term adverse events and beneficial cardiovascular outcomes in a ‘healthy’ cohort.

Participants and Methods

A cohort study of a healthy Tricare population (fiscal year [FY] 2002 through FY 2011) who have no cardiovascular disease, major comorbidities requiring medications, or functional limitations. Statin users used statins for 90–365 days during FY 2005 as their only prescription medication. Nonusers had medical encounters but did not receive prescription medications during FY 2005, and did not receive any statins throughout the study period from FY 2002 to FY 2011. Outcomes were the occurrence of major acute cardiovascular events, diabetes mellitus and its complications, kidney diseases, musculoskeletal diseases, obesity, cataracts, malignancy, and death.

Results

We matched 1525 statin users to 1525 nonusers. During the follow-up period (FY 2006 to FY 2011), statin users had significantly higher odds of developing diabetes and diabetic complications that persisted throughout follow-up (odds ratio [OR] 1.93, 95 % confidence interval [CI] 1.55–2.41 and OR 2.15, 95 % CI 1.20–3.86, respectively). Short-term statin use was not associated with decreased odds of major acute cardiovascular events (OR 1.17, 95 % CI 0.72–1.92). There were no differences in risks of kidney diseases, musculoskeletal diseases, or malignancy.

Conclusions

Short-term statin use for primary prevention in this healthy cohort was associated with an increased risk of long-term diabetes and diabetic complications without cardiovascular benefits. Further study using pragmatic studies and prospective observational studies appropriately equipped to eliminate unidentified confounders are urgently needed.

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Authors and Affiliations

  1. Medicine Services, VA North Texas Health Care System, 4500 S. Lancaster Rd #111E, Dallas, TX, 75216, USA

    Ishak A. Mansi & Eric M. Mortensen

  2. Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Ishak A. Mansi, Eric M. Mortensen & Ethan A. Halm

  3. Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Ishak A. Mansi, Song Zhang, Eric M. Mortensen & Ethan A. Halm

  4. Department of the Army, Patient Administration Systems and Biostatistics Activity (PASBA), Fort Sam Houston, TX, USA

    Jenny English

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Correspondence to Ishak A. Mansi.

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Funding

Drs. Halm and Mortensen were supported in part by a grant from the Agency for Healthcare Research and Quality (R24 HS022418) for the University of Texas Southwestern Center for Patient-Centered Outcomes Research.

No funding was provided for the conduct of this study. This material is the result of work supported with resources and the use of facilities at the VA North Texas Health Care System and the University of Texas Southwestern.

Conflicts of interest

Ishak Mansi, Jenny English, Song Zhang, Eric Mortensen, and Ethan Halm declare that they have no conflicts of interest that are directly relevant to the content of this study.

Disclaimer

The views expressed herein are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, VA Healthcare administration, or the US Government. The authors are employees of the US Government. This work was prepared as part of their official duties and, as such, there is no copyright to be transferred.

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Mansi, I.A., English, J., Zhang, S. et al. Long-Term Outcomes of Short-Term Statin Use in Healthy Adults: A Retrospective Cohort Study. Drug Saf 39, 543–559 (2016). https://doi.org/10.1007/s40264-016-0412-2

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