Importance of the lipid-related pathways in the association between statins, mortality and cardiovascular disease risk : the multi-ethnic study of atherosclerosis

DC FieldValueLanguage
dc.contributor.authorTalbot, Denis-
dc.contributor.authorDelaney, Joseph A. C.-
dc.contributor.authorSandfort, Veit-
dc.contributor.authorHerrington, David M.-
dc.contributor.authorMcClelland, Robyn L.-
dc.description.abstractPURPOSE: Estimating how much of the impact of statins on coronary heart diseases (CHD), cardiovascular disease (CVD), and mortality risk is attributable to their effect on low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides. METHODS: A semi-parametric g-formula estimator together with data from the Multi-Ethnic Study of Atherosclerosis (a prospective multi-center cohort study) was utilized to perform a mediation analysis. A total of 5280 participants, men and women of various race/ethnicities from multiple sites across the United States, were considered in the current study. RESULTS: The adherence adjusted total relative risk reduction (RRR) estimate (95% confidence interval) of statins on CHD was 14% (-16%, 37%), and the indirect component through LDL was 23% (-4%, 58%). For CVD, the total RRR was 23% (2%, 40%), and the indirect component through LDL was 5% (-13%, 25%). The total RRR of mortality was 18% (-1%, 35%), and the indirect component through LDL was -4% (-17%, 12%). The estimated indirect components through HDL and triglycerides were close to zero with narrow confidence intervals for all 3 outcomes. CONCLUSIONS: The estimated effect of statins on mortality, CVD, and CHD appeared to be independent of their estimated effect on HDL and triglycerides. Our study provides evidence that the preventive effect of statins on CHD could be attributed in large part to their effect on LDL. Our g-formula estimator is a promising approach to elucidate pathways, even if it is hard to make firm conclusions for the LDL pathway on mortality and CVDfr
dc.publisherInternational Society for Pharmacoepidemiologyfr
dc.subjectCardiovascular diseasesfr
dc.subjectCoronary diseasefr
dc.subjectHydroxymethylglutaryl-CoA reductase inhibitorsfr
dc.subjectMediation analysisfr
dc.titleImportance of the lipid-related pathways in the association between statins, mortality and cardiovascular disease risk : the multi-ethnic study of atherosclerosisfr
dc.typeCOAR1_1::Texte::Périodique::Revue::Contribution à un journal::Article::Article de recherchefr
dcterms.bibliographicCitationPharmacoepidemiology and drug safety, Vol. 27 (4), 365-372 (2018)fr
dc.subject.rvmArtères coronaires -- Maladiesfr
dc.subject.rvmCœur -- Maladiesfr
dc.subject.rvmLipoprotéines de basse densitéfr
dc.subject.rvmLipoprotéines de haute densitéfr
dc.subject.rvmHydroxyméthylglutaryl-CoA réductases -- Antagonistesfr
rioxxterms.versionAccepted Manuscriptfr
rioxxterms.project.funder_nameNational Heart, Lung, and Blood Institutefr
rioxxterms.project.funder_nameNational Center for Research Resourcesfr
bul.rights.periodeEmbargo12 moisfr
Collection:Articles publiés dans des revues avec comité de lecture

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