Associations between statins and coronary artery disease and stroke risks in patients with asthma-chronic obstructive pulmonary disease overlap syndrome: A time-dependent regression study

Abstract

Backgound and aims: We aimed at determining the effects of statin use on coronary artery disease (CAD) and stroke risks in patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS).

Methods: We retrospectively enrolled patients with ACOS treated with (N = 916) and without (N = 6338) statins. The cumulative incidence of CAD and stroke (ischemic and hemorrhagic) was analyzed through time-dependent Cox proportional regression. After adjustment for sex, age, comorbidities, inhaled corticosteroid steroid (ICS) use, and oral steroid (OS) use, we calculated the adjusted hazard ratios (aHRs) and their 95% confidence intervals (CIs) for CAD or stroke in the statin users (long-term [>600 days] and short-term [≤600 days]) compared with the non-users.

Results: Among the statin users, aHRs (95% CIs) for CAD and stroke were 0.50 (0.41-0.62) and 0.83 (0.63-1.09), respectively; moreover, aHRs were 0.30 (0.09-0.99) and 0.90 (0.68-1.20) for ischemic and hemorrhagic stroke, respectively. aHRs (95% CIs) for CAD and stroke were 0.58 (0.47-0.71) and 0.93 (0.70-1.23), respectively, in the short-term users and 0.23 (0.13-0.41) and 0.42 (0.19-0.89), respectively, in the long-term users.

Conclusions: CAD risk was lower in all statin users, regardless of the duration of use, whereas ischemic stroke risk was lower only in the long-term statin users. No association was observed between hemorrhagic stroke risk and statin use.

Keywords: Asthma–chronic obstructive pulmonary disease overlap syndrome; Coronary artery disease; Stroke.