Table 2.
Analysis of healthy user effect: event counts, rates, and rate ratios in statin initiators vs. matched noninitiators.
| Statin initiators (N = 38,585)
|
Noninitiators matched on age, sex, and state (N = 38,585)
|
Rate ratio, statin initiators vs. matched noninitiators (95% CI)† | |||
|---|---|---|---|---|---|
| N events | Rate† | N events | Rate* | ||
| Myocardial infarction | 370 | 1.09 | 355 | 1.08 | 0.98 (0.84, 1.13) |
| Death | 601 | 1.77 | 1110 | 3.36 | 0.58 (0.52, 0.64) |
| Nursing home admission | 1236 | 3.63 | 1794 | 5.43 | 0.69 (0.64, 0.75) |
| Preventive service use outcomes | |||||
| Composite–males | 5072 | 96.49 | 4,300 | 85.52 | 1.10 (1.06, 1.14) |
| Composite–females | 26,582 | 92.44 | 23,402 | 83.55 | 1.09 (1.07, 1.11) |
| Bone mineral density test‡ | 2351 | 8.59 | 1236 | 3.63 | 1.17 (1.11, 1.25) |
| Prostate specific antigen test§ | 1437 | 36.42 | 1228 | 32.42 | 1.08 (1, 1.16) |
| Fecal occult blood test‡ | 3639 | 11.49 | 3291 | 10.72 | 1.06 (1.01, 1.11) |
| Mammography‡ | 6245 | 25.48 | 5199 | 21.75 | 1.15 (1.11, 1.19) |
| Influenza vaccination | 15,099 | 56.58 | 13,444 | 50.82 | 1.09 (1.06, 1.12) |
| Pneumonia vaccination | 2265 | 6.89 | 1915 | 5.96 | 1.15 (1.08, 1.23) |
| Clinical outcomes not known to be related to statin use | |||||
| Composite | 15,772 | 46.37 | 17,462 | 52.85 | 0.87 (0.85, 0.89) |
| Asthma/COPD hospitalization among subjects with asthma/COPD | 736 | 13.2 | 1141 | 19.96 | 0.70 (0.64, 0.77) |
| Burns | 139 | 0.41 | 117 | 0.35 | 1.16 (0.90, 1.49) |
| Dental problems | 92 | 0.27 | 107 | 0.32 | 0.86 (0.65, 1.14) |
| Diverticulitis | 2793 | 8.56 | 2757 | 8.71 | 0.99 (0.94, 1.05) |
| Falls | 1227 | 3.66 | 1567 | 4.83 | 0.78 (0.72, 0.84) |
| Food-borne bacterial illness | 359 | 1.06 | 389 | 1.18 | 0.90 (0.78, 1.05) |
| Fractures | 1774 | 5.34 | 2216 | 6.91 | 0.81 (0.76, 0.86) |
| Gall stones | 693 | 2.06 | 697 | 2.13 | 0.97 (0.87, 1.08) |
| Gout | 848 | 2.53 | 732 | 2.24 | 1.03 (0.94, 1.14) |
| Kidney stones | 424 | 1.25 | 409 | 1.25 | 0.99 (0.86, 1.14) |
| Malignant melanoma | 110 | 0.32 | 113 | 0.34 | 0.99 (0.76, 1.3) |
| Migraine | 311 | 0.92 | 302 | 0.92 | 1.00 (0.85, 1.17) |
| Motor vehicle accident | 103 | 0.3 | 73 | 0.22 | 1.41 (1.04, 1.91) |
| Open wound | 977 | 2.91 | 1186 | 3.65 | 0.81 (0.74, 0.88) |
| Peptic ulcer/gastrointestinal bleed | 2061 | 6.24 | 2201 | 6.87 | 0.91 (0.86, 0.97) |
| Poisoning | 272 | 0.8 | 281 | 0.85 | 0.97 (0.82, 1.15) |
| Sexually transmitted disease | 103 | 0.3 | 85 | 0.26 | 1.15 (0.86, 1.54) |
| Skin infections | 2358 | 7.19 | 2558 | 8.05 | 0.89 (0.85, 0.95) |
CI, confidence interval; COPD, chronic obstructive pulmonary disease.
Rate is per 100 person-years.
Rate ratios for individual outcomes were estimated from a Cox proportional hazards regression stratified on age, sex, and state of residence, and adjusted for race, Charlson comorbidity score, number of medications used, physician visits, days in hospital, and days in nursing home during the baseline period, and history during the baseline period of chronic obstructive pulmonary disease, obesity, stroke or transient ischemic attack, hypertension, congestive heart failure, atrial fibrillation, dementia, depression, liver disease, rheumatoid arthritis, osteoarthritis, hip fracture, and cancer (model 2). Rate ratios for composite outcomes were estimated using a Poisson regression adjusted for the same covariates.
Prostate specific antigen test, fecal occult blood test, and mammography analyses were restricted to subjects without a history of the cancer detected by the screening test. Bone mineral density testing analysis was restricted to women without a history of hip fracture.