Lipid Lowering Medications and Risk of Injury. Abstract, and Executive ofDissertation

摘要

Early primary prevention trials of lipid lowering therapies reducedcardiovascular disease but not total mortality. Meta-analyses showed increased injury deaths (chiefly motor vehicle collisions, suicide, and homicide) among persons treated to lower cholesterol. We conducted a population-based case-control study to examine the association of lipid lowering medication use with death of hospitalization resulting from motor vehicle collisions or intentional injuries. Cases (n=298) were identified using diagnostic databases. Controls (n=332) were frequency matched to cases on age sex, and year of presentation. Use of lipid lowering medication was assessed from pharmacy data. Covariates were assessed from databases and medical records. Current use of lipid lowering medications was not associated with injury in unadjusted analyses (odds ratio (OR) = 0.58, 95% confidence interval (CI) 0.24-1.40) or in analyses adjusted for matching variables, behavioral disorders, clinical heart disease, and health status (OR = 0.36 95% CIO. 13-0.98). Past use was not associated with injury in either unadjusted (OR=1.03,95%CI 0.52-2.05) or adjusted analyses (OR = 1.00, 95%CI 0.47-2.15). Stratified analyses did not reveal any patient sub-groups at increased injury risk. We found no evidence of an association between use of lipid lowering medications and injury. These findings are consistent with more recent randomized clinical trials, recent meta-analyses, and current treatment guidelines.