Differences in preventing new‐onset cardiovascular events with statin therapy in seniors aged 75 years and over: A cohort study in the South Korean National Health Insurance Database

The incidence of sudden cardiac arrest (SCA) in Asians is lower than that seen in Western populations, but there are few available data on the incidence and associated cardiac etiology of SCA in Asians. From 2002 to 2013, patients with SCA were analyzed using a cohort from the South Korean National Health Insurance Service (NHIS) coded database. Sudden unexplained death syndrome (SUDS) was defined as cryptogenic arrest, excluding that of non-cardiac origin, coronary artery disease (CAD), cardiomyopathy (CM), and valvular heart disease. During the 12-year study period, 5,973 patients (0.53%) from the total cohort of 1,125,691 had a cardiac arrest code. The overall incidence of arrest was 48.7 per 100,000 person-years (95% CI 16.6–18.0). The incidence of primary SCA excluding those of non-cardiac origin was 16.1 per 100,000 person-years (95% CI 15.4–16.8). It was higher in males than in females (18.1 vs. 14.1 per 100,000 person-years). CAD was the most common cause of SCA (59.4%), and followed by CM (13.9%). SUDS accounted for 14.7% of SCA events. The risk of SCA had increased gradually from over 25 years old. Heart failure, atrial fibrillation and hypertension are major factors associated with SCA incidence. Our findings outline epidemiologic data for SCA and the proportion of associated cardiac etiology leads SCA in a large population.

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Fenofibrate Use Is Associated With Lower Mortality and Fewer Cardiovascular Events in Patients With Diabetes: Results of 10,114 Patients From the Korean National Health Insurance Service Cohort

10.2337/figshare.14597091.v1 ◽

2021 ◽

Author(s):

Sang-Ho Jo ◽

Hyewon Nam ◽

Jeongwoo Lee ◽

Sojeong Park ◽

Jungkuk Lee ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Primary Endpoint ◽

Cardiac Death ◽

Cardiovascular Events ◽

Coronary Revascularization ◽

Korean National Health Insurance

Objective: We investigate long term clinical efficacy of fenofibrate use on mortality and cardiovascular outcomes in patients with type 2 diabetes. Research design and Methods: We performed population based cohort study using data of Korean National Health Insurance from 2003 to 2014. Among 63727 participants with diabetes aged 40-79, 5057 users of fenofibrate only were compared with 5057 non-users of fenofibrate and/or omega-3 fatty acid with 1:1 propensity matching. Primary endpoint was composite of myocardial infarction, stroke, percutaneous coronary revascularization and cardiac death for median 3 years. Results: Primary endpoint was significantly lower in fenofibrate users as compared to neither users, 13.4 vs. 15.5 per 1000 person years (hazard ratio [HR] 0.76, confidence interval [CI], 0.62-0.94, P=0.010). Cardiac death (1.8 vs. 3.1 per 1000 person years [HR 0.59, CI, 0.352- 0.987, p=0.0446]), all cause death (7.6 vs. 15.3 per 1000 person years [HR 0.437, CI, 0.340 -0.562, p<0.0001]), and stroke (6.5 vs. 8.6 per 1000 person years [HR 0.621, CI, 0.463-0.833, P=0.0015]) were significantly lower in fenofibrate group. As the duration of fenofibrate use stratified by quartiles (Q1-4), the risk decreased in Q4 with HR of 0.347 (95% CI 0.226-0.532, P<0.0001). In subgroup analysis, the favoring effect of fenofibrate is sustained consistently across all subset of patients including those classified by LDL-C, HDL-C and TG levels. Conclusions: Use of fenofibrate was associated with lower rate of total and cardiac mortality and cardiovascular events in type 2 diabetes patients for 3 year follow-up in real world large populations.

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