Table 4. Adherence to diabetes medications (oral hypoglycemic agents or insulin) and risk of CVD event in the Pathways Heart Study.
| Outcome | MSM Parameter-ization | Person-Time | Reference Exposure* | %† | Non-reference Exposure* | %† | Super learner HR (95% CI)‡ |
|---|---|---|---|---|---|---|---|
| Heart Failure (n = 193) | 1 | 40,736 | CAA = 100% | 65 | CAA<100% | 35 | 0.83 (0.22–3.15) |
| 2 | 40,736 | CAA≥80% | 40 | CAA<80% | 60 | 0.96 (0.27–3.50) | |
| 3 | 40,736 | CAA = 100% | 40 | CAA<80% | 25 | 0.91 (0.24–3.43) | |
| 0.8≤CAA<100% | 35 | 0.27 (0.05–1.37) | |||||
| Ischemic Heart Disease (n = 149) | 1 | 39,317 | CAA = 100% | 65 | CAA<100% | 35 | 0.15 (0.05–0.47) |
| 2 | 39,317 | CAA≥80% | 40 | CAA<80% | 60 | 0.12 (0.04–0.42) | |
| 3 | 39,317 | CAA = 100% | 40 | CAA<80% | 25 | 0.12 (0.03–0.41) | |
| 80%≤CAA<100% | 35 | 0.33 (0.09–1.23) | |||||
| Stroke (n = 66) | 1 | 43,108 | CAA = 100% | 66 | CAA<100% | 34 | 5.23 (0.87–31.60) |
| 2 | 43,108 | CAA≥80% | 41 | CAA<80% | 59 | 6.06 (0.90–40.74) | |
| 3 | 43,108 | CAA = 100% | 41 | CAA<80% | 25 | 6.15 (0.90–42.13) | |
| 80%≤CAA<100% | 34 | 1.16 (0.21–6.36) | |||||
| All CVD (n = 291) | 1 | 36,429 | CAA = 100% | 64 | CAA<100% | 36 | 0.43 (0.15–1.26) |
| 2 | 36,429 | CAA≥80% | 39 | CAA<80% | 61 | 0.52 (0.17–1.59) | |
| 3 | 36,429 | CAA = 100% | 39 | CAA<80% | 25 | 0.48 (0.16–1.49) | |
| 80%≤CAA<100% | 36 | 0.21 (0.06–0.70) |
* Exposure level indicates a patient’s cumulative average adherence (CAA) up to the risk set that defines each hazard ratio (HR) and 95% confidence interval (CI)
† Proportion of cohort in exposed group
‡ Stabilized, truncated at 20, inverse probability weighting HR estimates. An HR>1 indicates that the non-reference exposure level is deleterious.