Abstract
Background
Statins have been associated with later life, long-term care admission in observational studies. However, by preventing vascular events, statins may also prevent or delay admission. We wished to determine statin and long-term care admission associations in a randomised controlled trial context, and describe associations between long-term care admission and other clinical and demographic factors.
Methods
We used extended follow-up of two randomised trial populations, using national data to assign the long-term care admission outcome, and included individuals screened or recruited to two large randomised trials of pravastatin 40 mg daily—the West of Scotland Coronary Prevention Study (WOSCOPS) and the pravastatin in elderly individuals at risk of vascular disease (PROSPER) study. We described univariable and multivariable analyses of potential predictors of long-term care admission with corresponding survival curves of incident long-term care admission and analyses adjusted for competing risk.
Results
In total 11,015 (10%) of the trial participants were admitted to long-term care. There was no difference between participants in the statin or placebo arms of either trial in regard to admissions to long-term care. On multivariable analyses, independent associations with incident long-term care admission in the PROSPER trial were age (hazard ratio [HR] 1.06 per year, 95% confidence interval [CI] 1.03–1.09) and male sex (HR 0.72, 95% CI 0.53–0.99). In the WOSCOPS, age (HR 1.12 per year, 95% CI 1.10–1.13) and increasing social deprivation (HR 1.05, 95% CI 1.03–1.08) were associated with incident long-term care admission.
Conclusion
We did not demonstrate an association between historical statin use and future long-term care admission. The strongest associations with incident long-term care admission were non-modifiable factors of age, sex and socioeconomic deprivation.
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JKB drafted the manuscript; RP, CH, CM, IF handled the data management and analyses; and DJS and TJQ created the protocol and awarded funding. All authors contributed to interpretation of data and the final manuscript.
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This work was supported by the NHS Scotland, Chief Scientist Office (HICG/1/14).
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Jennifer K. Burton, Richard Papworth, Caroline Haig, Colin McCowan, Ian Ford, and Terence J. Quinn declare that they have no relevant conflicts of interest that may be relevant to this manuscript. David J. Stott received research funding support from Bristol-Myers Squibb for the PROSPER and WOSCOPS studies.
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The sponsors played no part in the design, conduct or analysis of this study.
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Burton, J.K., Papworth, R., Haig, C. et al. Statin Use is Not Associated with Future Long-Term Care Admission: Extended Follow-Up of Two Randomised Controlled Trials. Drugs Aging 35, 657–663 (2018). https://doi.org/10.1007/s40266-018-0560-4
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DOI: https://doi.org/10.1007/s40266-018-0560-4