Use of Statins and Risk of Dementia in Heart Failu

Authors: Abhishek S Chitnis Rajender R Aparasu Hua Chen Mark E Kunik Paul E Schulz Michael L Johnson

Publish Date: 2015/09/12

Volume: 32, Issue: 9, Pages: 743-754

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Abstract

Heart failure HF is associated with an increased risk of dementia and studies show that dyslipidemia may be involved in the pathogenesis of dementia However it is unclear whether 3hydroxy3methylglutaryl coenzyme A HMGCoA reductase inhibitors statins are associated with a lower risk of dementia in HF patients The present study examines the effectiveness of statins to prevent dementia in HF patientsThis retrospective longitudinal study used a cohort of patients with HF identified from a local US Medicare Advantage Prescription Drug plan to examine the incidence of dementia with up to 3 years of followup A multivariable timedependent Cox model and inverseprobabilityoftreatment weighting IPTW of the marginal structural model were used to estimate the risk of developing dementia Adjusted dementia rate ratios were estimated among current and former statin users as compared with nonusersThe study included a total of 8062 HF patients mean age 7447 ± 921 years of whom 1135 1408  were diagnosed with dementia during a median followup of 22 months Using the timedependent Cox model the adjusted dementia rate ratios among current and former users were 093 95  confidence interval CI 071–121 and 099 95  CI 079–125 respectively Use of IPTW resulted in similar findings of 124 95  conservative CI 089–172 among current users and 094 95  conservative CI 067–131 among former users as compared with nonusers

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