Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review

<h3>Purpose</h3><p dir="ltr">Statins are widely prescribed for cardiovascular diseases (CVD) prevention; however, a significant proportion of users discontinue the medication for various reasons. This review aimed to determine the prevalence of statin therapy discontinuat...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Shahd A. Ageeb (22047824) (author)
مؤلفون آخرون: Alaa Abdelmoghith (22047827) (author), Hager ElGeed (20642703) (author), Ahmed Awaisu (5121473) (author), Abdulmoniem ElMansor (22047830) (author), Yaw B. Owusu (22047833) (author)
منشور في: 2024
الموضوعات:
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author Shahd A. Ageeb (22047824)
author2 Alaa Abdelmoghith (22047827)
Hager ElGeed (20642703)
Ahmed Awaisu (5121473)
Abdulmoniem ElMansor (22047830)
Yaw B. Owusu (22047833)
author2_role author
author
author
author
author
author_facet Shahd A. Ageeb (22047824)
Alaa Abdelmoghith (22047827)
Hager ElGeed (20642703)
Ahmed Awaisu (5121473)
Abdulmoniem ElMansor (22047830)
Yaw B. Owusu (22047833)
author_role author
dc.creator.none.fl_str_mv Shahd A. Ageeb (22047824)
Alaa Abdelmoghith (22047827)
Hager ElGeed (20642703)
Ahmed Awaisu (5121473)
Abdulmoniem ElMansor (22047830)
Yaw B. Owusu (22047833)
dc.date.none.fl_str_mv 2024-08-13T09:00:00Z
dc.identifier.none.fl_str_mv 10.1002/pds.5879
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Prevalence_Associated_Risk_Factors_and_Adverse_Cardiovascular_Outcomes_of_Statins_Discontinuation_A_Systematic_Review/29900675
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
Public health
Statins
Cardiovascular disease (CVD)
All-cause mortality
Risk factors
Smoking
Uninsured patients
Ethnic disparities
dc.title.none.fl_str_mv Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Purpose</h3><p dir="ltr">Statins are widely prescribed for cardiovascular diseases (CVD) prevention; however, a significant proportion of users discontinue the medication for various reasons. This review aimed to determine the prevalence of statin therapy discontinuation, its associated factors, and adverse cardiovascular outcomes within the first year of discontinuation.</p><h3>Methods</h3><p dir="ltr">The PubMed, EMBASE, ScienceDirect, SCOPUS, and Google Scholar databases were systematically searched from their inception to December 2022. Manual searches were also conducted on the bibliographies of relevant articles. Studies were included for qualitative data synthesis and assessed for methodological quality.</p><h3>Results</h3><p dir="ltr">Fifty‐two studies, predominantly cohort studies (n = 38), involving 4 277 061 participants were included. The prevalence of statin discontinuation within the first year of statin initiation ranged from 0.8% to 70.5%, which was higher for primary prevention indications. Factors frequently associated with an increased likelihood of statin discontinuation included male sex, nonWhite ethnicity, smoking status, and being uninsured. Conversely, discontinuation was less likely in patients with CVD who received secondary prevention statin therapy and in patients with polypharmacy. Furthermore, age showed diverse and inconsistent relationships with statin discontinuation among various age categories. Five studies that reported the cardiovascular risk of statin discontinuation within the first year of initiation showed significantly increased risk of discontinuation, including all‐cause mortality (hazard ratio: 1.36–3.65).</p><h3>Conclusion</h3><p dir="ltr">Our findings indicate a high prevalence of statin discontinuation and an increased likelihood of adverse cardiovascular outcomes within the first year of discontinuation, despite wide variability across published studies. This review highlights the importance of addressing the modifiable risk factors associated with statin discontinuation, such as smoking and lack of insurance coverage.</p><h2>Other Information</h2><p dir="ltr">Published in: Pharmacoepidemiology and Drug Safety<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/pds.5879" target="_blank">https://dx.doi.org/10.1002/pds.5879</a></p>
eu_rights_str_mv openAccess
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identifier_str_mv 10.1002/pds.5879
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/29900675
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spelling Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic ReviewShahd A. Ageeb (22047824)Alaa Abdelmoghith (22047827)Hager ElGeed (20642703)Ahmed Awaisu (5121473)Abdulmoniem ElMansor (22047830)Yaw B. Owusu (22047833)Biomedical and clinical sciencesCardiovascular medicine and haematologyPharmacology and pharmaceutical sciencesHealth sciencesEpidemiologyPublic healthStatinsCardiovascular disease (CVD)All-cause mortalityRisk factorsSmokingUninsured patientsEthnic disparities<h3>Purpose</h3><p dir="ltr">Statins are widely prescribed for cardiovascular diseases (CVD) prevention; however, a significant proportion of users discontinue the medication for various reasons. This review aimed to determine the prevalence of statin therapy discontinuation, its associated factors, and adverse cardiovascular outcomes within the first year of discontinuation.</p><h3>Methods</h3><p dir="ltr">The PubMed, EMBASE, ScienceDirect, SCOPUS, and Google Scholar databases were systematically searched from their inception to December 2022. Manual searches were also conducted on the bibliographies of relevant articles. Studies were included for qualitative data synthesis and assessed for methodological quality.</p><h3>Results</h3><p dir="ltr">Fifty‐two studies, predominantly cohort studies (n = 38), involving 4 277 061 participants were included. The prevalence of statin discontinuation within the first year of statin initiation ranged from 0.8% to 70.5%, which was higher for primary prevention indications. Factors frequently associated with an increased likelihood of statin discontinuation included male sex, nonWhite ethnicity, smoking status, and being uninsured. Conversely, discontinuation was less likely in patients with CVD who received secondary prevention statin therapy and in patients with polypharmacy. Furthermore, age showed diverse and inconsistent relationships with statin discontinuation among various age categories. Five studies that reported the cardiovascular risk of statin discontinuation within the first year of initiation showed significantly increased risk of discontinuation, including all‐cause mortality (hazard ratio: 1.36–3.65).</p><h3>Conclusion</h3><p dir="ltr">Our findings indicate a high prevalence of statin discontinuation and an increased likelihood of adverse cardiovascular outcomes within the first year of discontinuation, despite wide variability across published studies. This review highlights the importance of addressing the modifiable risk factors associated with statin discontinuation, such as smoking and lack of insurance coverage.</p><h2>Other Information</h2><p dir="ltr">Published in: Pharmacoepidemiology and Drug Safety<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/pds.5879" target="_blank">https://dx.doi.org/10.1002/pds.5879</a></p>2024-08-13T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1002/pds.5879https://figshare.com/articles/journal_contribution/Prevalence_Associated_Risk_Factors_and_Adverse_Cardiovascular_Outcomes_of_Statins_Discontinuation_A_Systematic_Review/29900675CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/299006752024-08-13T09:00:00Z
spellingShingle Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review
Shahd A. Ageeb (22047824)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
Public health
Statins
Cardiovascular disease (CVD)
All-cause mortality
Risk factors
Smoking
Uninsured patients
Ethnic disparities
status_str publishedVersion
title Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review
title_full Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review
title_fullStr Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review
title_full_unstemmed Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review
title_short Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review
title_sort Prevalence, Associated Risk Factors, and Adverse Cardiovascular Outcomes of Statins Discontinuation: A Systematic Review
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Pharmacology and pharmaceutical sciences
Health sciences
Epidemiology
Public health
Statins
Cardiovascular disease (CVD)
All-cause mortality
Risk factors
Smoking
Uninsured patients
Ethnic disparities