scholarly journals Comparison of Time-Varying and Landmark Analysis Methods in Estimating the Association Between Medication Adherence and Outcomes: A Heart Failure Cohort

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Xiwen Simon Qin ◽  
Matthew W Knuiman ◽  
Joseph Hung ◽  
Tom Briffa ◽  
Tiew-Hwa Katherine Teng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cox Regression ◽  
Adverse Outcomes ◽  
Time Dependent ◽  
Time Varying ◽  
Landmark Analysis ◽  
Hazard Ratios ◽  
Β Blockers ◽  
Landmark Analyses

IntroductionMedication adherence is associated with a reduction of adverse outcomes in heart failure (HF). However, this association is complex to estimate accurately because adherence (exposure) can vary during the follow-up period. Adherence can be estimated as a fixed exposure to predict outcomes, and this is known as a landmark analysis. In contrast, adherence can also be estimated as a dynamic exposure which varies over time in the follow-up period. This is known as a time-varying analysis and is expected to be the more precise method. Objectives and ApproachWe compared these two methods in a HF cohort. We identified a population-based cohort of 3619 heart failure patients, aged 65-84 years hospitalised in Western Australia from 2003-2007 and who survived to 1-year post-discharge (landmark date). Adherence to renin-angiotensin system inhibitors (RASI) and β-blockers was calculated using proportion of days covered (PDC) expressed either as a fixed time exposure (in landmark analysis) or a varying exposure (in time-dependent analysis). The latter was updated every 30 days after the landmark date. Cox regression models were used to investigate the association between adherence and all-cause death at 1- and 3-years post-landmark date. ResultsFor 1-year outcomes, hazard ratios (HR) for every 10% increase in PDC were similar between models from landmark analyses (RASI adherence: 0.93, 0.90-0.97; β-blocker adherence: 0.96, 0.92-1.0) and time-dependent analyses (RASI adherence: 0.94, 0.91-0.97; β-blockers adherence: 0.95, 0.92 -0.99). However, 95% confidence intervals estimated from time-dependent models were narrower than those from landmark analyses. HRs were slightly closer to the null when estimated from time-dependent models. A similar pattern was seen with 3-year outcomes. Conclusion / ImplicationsTime-dependent analysis of adherence-outcome associations results in more precise estimates of hazard ratios. Estimates of HRs from landmark analysis models were similar but usually lower than those from time-dependent models.

Abstract P382: Fried Food Consumption is Associated with a Higher Risk of Heart Failure among US Male Physicians

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Luc Djousse ◽  
Andrew Petrone ◽  
John M Gaziano
Keyword(s):  
Heart Failure ◽  
Food Intake ◽  
Food Consumption ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Health Study ◽  
Median Frequency ◽  
Fried Food ◽  
Hazard Ratios

Background: While previous studies have reported a positive relation of fried food consumption with type 2 diabetes, hypertension, and obesity, no previous study has examined the relation of total fried food intake with risk of heart failure (HF) in a prospective cohort. Objective: To test the hypothesis that fried food consumption is positively associated with risk of HF in male physicians. Methods: A prospective cohort of 19,968 participants from the Physicians’ Health Study. Frequency of fried food consumption was assessed between 1999 and 2002 using a food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted hazard ratios of HF. Results: During a median follow-up of 10.6 years, 862 cases of HF occurred. The mean age at baseline was 66.4 ± 9.2 years. Median frequency of fried food consumption was <1 time per week. Multivariable adjusted hazard ratios (95% CI) were: 1.0 (ref), 1.18 (1.01-1.37), 1.25 (1.02-1.54), and 1.68 (1.19-2.36) for fried food consumption of <1/week, 1-3/week, 4-6/week, and 7+/week, respectively (p for linear trend: 0.0004), after adjustment for age, alcohol use, smoking, exercise, and history of myocardial infarction, coronary artery bypass graph or angioplasty (Fig). Additional adjustment of total trans fats did not alter the findings. In a secondary analysis, body mass index did not modify the relation of fried foods with HF risk. Conclusions: Our data show a positive association between fried food intake and risk of HF in US male physicians.

Abstract 3230: Elevated Glucose and Mortality in Patients Hospitalized with Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Mikhail Kosiborod ◽  
Silvio Inzucchi ◽  
John A Spertus ◽  
Yongfei Wang ◽  
Frederick A Masoudi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cox Regression ◽  
Linear Trend ◽  
Adverse Outcomes ◽  
Entire Cohort ◽  
Hazard Ratios ◽  
Elevated Glucose ◽  
Nationally Representative ◽  
Support Resource ◽  
The Impact

Background: While some professional societies recommend target-driven blood glucose (BG) control for all hospitalized patients, the association between elevated BG and adverse outcomes has not been well established in patients hospitalized with heart failure (HF). Methods: We evaluated a nationally representative cohort of 50,532 patients hospitalized with HF between 04/1998 – 06/2001. Admission BG was analyzed as a categorical variable (≤110, >110 –140, >140 –170, >170 –200, >200 mg/dL), and in 10 mg/dL increments. The association between BG and all-cause mortality over 30 days and 1 year was analyzed using Cox regression, both in the entire cohort and in patients with and without diabetes (DM). Results: After multivariable adjustment, there was no significant relationship between BG and 30-day mortality (for BG >110 to 140, >140 to 170, >170 to 200, and >200, hazard ratios and 95% confidence intervals were: 1.09 (0.98 –1.22), 1.27 (1.11–1.45), 1.16 (0.98–1.37), 1.00 (0.87–1.15) respectively vs. BG ≤110, P for linear trend 0.53). Results were similar for 1-year mortality, and did not differ between patients with and without DM (P values for DM*BG interaction 0.11 and 0.55 for 30-day and 1-year mortality respectively). A lack of association between BG and mortality over 30-days and 1-year was also observed when BG was analyzed in 10mg/dL increments (Figure ). Conclusions: We found no significant association between BG and mortality in a large cohort of hospitalized HF patients. While the impact of BG lowering on outcomes cannot be determined based on this study, our findings do not support resource-intensive interventions for BG monitoring and management in this patient group.

P5656Heart failure clinical phenotypes and outcomes in patients with atrial fibrillation: an analysis from the eurobservational research programme in atrial fibrillation long-term general registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Proietti ◽  
C Laroche ◽  
A Tello-Montoliu ◽  
R Lenarczyk ◽  
G A Dan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Regression Analysis ◽  
Cox Regression ◽  
Adverse Outcomes ◽  
Cox Regression Analysis ◽  
Coronary Syndrome

Abstract Introduction Heart failure (HF) is a well-known risk factor for atrial fibrillation (AF). Moreover, HF is associated with worse clinical outcomes in patients with known AF. Recently, phenotypes of HF have been redefined according to the level of ejection fraction (EF). New data are needed to understand if a differential risk for outcomes exists according to the new phenotypes' definitions. Purpose To evaluate the risk of major adverse outcomes in patients with AF and HF according to HF clinical phenotypes. Methods We performed a subgroup analysis of AF patients enrolled in the EORP-AF Long-Term General Registry with a history of HF at baseline, available EF and follow-up data. Patients were categorized as follows: i) EF<40%, i.e. HF reduced EF [HFrEF]; ii) EF 40–49%, i.e. HF mid-range EF [HFmrEF]; iii) EF ≥50%, i.e. HF preserved EF [HFpEF]. Any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death, CV death and all-cause death were recorded. Results A total of 3409 patients were included in this analysis: of these, 907 (26.6%) had HFrEF, 779 (22.9%) had HFmrEF and 1723 (50.5%) had HFpEF. An increasing proportion with CHA2DS2-VASc ≥2 was found across the three groups: 90.4% in HFrEF, 94.6% in HFmrEF and 97.3% in HFpEF (p<0.001), while lower proportions of HAS-BLED ≥3 were seen (28.0% in HFrEF, 26.3% in HFmrEF and 23.6% in HFpEF, p=0.035). At discharge patients with HFpEF were less likely treated with antiplatelet drugs (22.0%) compared to other classes and were less prescribed with vitamin K antagonists (VKA) (57.0%) and with any oral anticoagulant (OAC) (85.7%). No differences were found in terms of non-vitamin K antagonist oral anticoagulant use. At 1-year follow-up, a progressively lower rate for all study outcomes (all p<0.001), with an increasing cumulative survival, was found across the three groups, with patients with HFpEF having better survival (all p<0.0001 for Kaplan-Meier curves). After full adjustment, Cox regression analysis showed that compared to HFrEF, HFmrEF and HFpEF were associated with risk of all study outcomes (Table). Cox Regression Analysis HR (95% CI) Any TE/ACS/CV Death CV Death All-Cause Death HFmrEF 0.65 (0.49–0.86) 0.53 (0.38–0.74) 0.55 (0.41–0.74) HFpEF 0.50 (0.39–0.64) 0.42 (0.31–0.56) 0.45 (0.35–0.59) ACS = Acute Coronary Syndrome; CI = Confidence Interval; CV = Cardiovascular; EF = Ejection Fraction; HF = Heart Failure; HR = Hazard Ratio. Conclusions In this cohort of AF patients with HF, HFpEF was the most common phenotype, being associated with a profile related to an increased thromboembolic risk. Compared to HFrEF, both HFmrEF and HFpEF were associated with a lower risk of all major adverse outcomes in AF patients.

Severe Hypoglycemia and Incident Heart Failure among Adults With Type 2 Diabetes

2021 ◽  
Author(s):  
Justin B Echouffo-Tcheugui ◽  
Arnaud D Kaze ◽  
Gregg C Fonarow ◽  
Sam Dagogo-Jack
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Relative Risk ◽  
Cox Regression ◽  
Severe Hypoglycemia ◽  
Medical Assistance ◽  
Hazard Ratios ◽  
Accord Study

Abstract Context The effect of severe hypoglycemia on the incidence of heart failure (HF) is unclear. Objective We evaluated the association of severe hypoglycemia with incident HF among individuals with type 2 diabetes. Methods We included participants with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. Severe hypoglycemia episodes were assessed during the initial 24 months following randomization and defined using two methods: symptomatic, severe hypoglycemic event requiring medical assistance (first definition) or requiring any assistance (second definition). Participants without HF at baseline and during the first 24 months of the study were prospectively followed for incident HF hospitalization. Multivariable Cox regression was used to generate adjusted hazard ratios (HR) for the association of severe hypoglycemia and incident HF. Results Among 9,208 participants (mean age 63 years, 38% female, 62% White), 365 had ≥ 1 episode of severe hypoglycemic. Over a median follow-up of 3 years, there were 249 incident HF events. After multivariable adjustment for relevant confounders, participants with severe hypoglycemia requiring medical assistance had a 68% higher relative risk of incident HF (HR 1.68, 95% CI 1.06-2.66), as compared to individuals who never experienced any episode of hypoglycemia. Severe hypoglycemia requiring any assistance was also associated with a 49% higher relative risk of HF (HR 1.49, 95% CI 1.01-2.21). Conclusion In a large cohort of adults with type 2 diabetes, severe hypoglycemia was independently associated with greater risk of incident HF.

scholarly journals Heart rate and adverse outcomes in patients with prevalent atrial fibrillation

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001606
Author(s):  
Giorgio Moschovitis ◽  
Linda S B Johnson ◽  
Steffen Blum ◽  
Stefanie Aeschbacher ◽  
Maria Luisa De Perna ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Rate ◽  
Cox Regression ◽  
Threshold Effect ◽  
Adverse Outcomes ◽  
Systemic Embolism ◽  
Target Heart Rate ◽  
Heart Failure Hospitalisation

ObjectiveThe optimal target heart rate in patients with prevalent atrial fibrillation (AF) is not well defined. The aim of this study was to analyse the associations between heart rate and adverse outcomes in a large contemporary cohort of patients with prevalent AF.MethodsFrom two prospective cohort studies, we included stable AF outpatients who were in AF on the baseline ECG. The main outcome events assessed during prospective follow-up were heart failure hospitalisation, stroke or systemic embolism and death. The associations between heart rate and adverse outcomes were evaluated using multivariable Cox regression models.ResultsThe study population consisted of 1679 patients who had prevalent AF at baseline. Mean age was 74 years, and 24.6% were women. The mean heart rate on the baseline ECG was 78 (±19) beats per minute (bpm). The median follow-up was 3.9 years (IQR 2.2–5.0). Heart rate was not significantly associated with heart failure hospitalisation (adjusted HR (aHR) per 10 bpm increase, 1.00, 95% CI 0.94 to 1.07, p=0.95), stroke or systemic embolism (aHR 0.95, 95% CI 0.84 to 1.07, p=0.38) or death (aHR 1.02, 95% CI 0.95 to 1.09, p=0.66). There was no evidence of a threshold effect for heart rates <60 bpm or >100 bpm.ConclusionsIn this large contemporary cohort of outpatients with prevalent AF, we found no association between heart rate and adverse outcome events. These data are in line with recommendations that strict heart rate control is not needed in otherwise stable outpatients with AF.

Abstract P413: Chocolate Consumption is Associated with a Lower Risk of Heart Failure in Lean US Male Physicians

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Andrew B Petrone ◽  
J. Michael Gaziano ◽  
Luc Djousse
Keyword(s):  
Heart Failure ◽  
Lower Risk ◽  
Cox Regression ◽  
Secondary Analysis ◽  
Health Study ◽  
Adjusted Relative Risk ◽  
Hazard Ratios ◽  
Lower Blood ◽  
History Of

Background: Previous studies have suggested that dark chocolate consumption may lower blood pressure, a major risk factor for heart failure. However, limited and inconsistent data are available on the association of chocolate consumption with the incidence rate of heart failure. Objective: To test the hypothesis that chocolate consumption is associated with a lower risk of heart failure. Methods: We prospectively studied 20,278 men from the Physicians’ Health Study. Chocolate consumption was assessed between 1999 and 2002 via a food frequency questionnaire and heart failure was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted relative risk of heart failure. Results: During a median follow-up of 9.3 years, there were 876 new cases of heart failure. The mean age at baseline was 66.4 ± 9.2 years. Median chocolate consumption was 1-3 times per month. Hazard ratios (95% CI) for heart failure were 1.0 (ref), 0.87 (0.73-1.04), 0.80 (0.66-0.98), and 0.87 (0.72-1.04), for chocolate consumption of less than 1/month, 1-3/month, 1/week, and 2+/week, respectively, after adjusting for age, body mass index (BMI), smoking, alcohol intake, exercise, and history of atrial fibrillation. In a secondary analysis, chocolate consumption was inversely associated with risk of heart failure in men whose BMI was <25 kg/m 2 but not in those with BMI of 25+ kg/m 2 ( Figure 1 ), p for interaction=0.0895. Conclusions: Our data suggest that moderate consumption of chocolate might be associated with a lower risk of heart failure, especially in lean individuals.

Abstract 14337: Antihypertensive Class and Cardiovascular Outcomes in Patients With HIV and Hypertension

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Leah B Rethy ◽  
Matthew J Feinstein ◽  
Chad J Achenbach ◽  
Raymond R Townsend ◽  
Adam P Bress ◽  
...  
Keyword(s):  
Heart Failure ◽  
Propensity Score ◽  
Cox Regression ◽  
Enzyme Inhibitor ◽  
Hypertension Management ◽  
Increased Risk ◽  
High Prevalence ◽  
Β Blocker ◽  
Β Blockers

Background: People with HIV(PWH) have a high risk of hypertension and hypertension-related cardiovascular diseases (CVD). Objectives: Given unique pathways contributing to hypertension among PWH, we sought to determine whether antihypertensive class was associated with CVD events in PWH. Methods: Among veterans with HIV and new onset hypertension (2000-2019), we used propensity score-matching with Cox regression to evaluate the risk of CVD events (ischemic heart disease, heart failure, stroke) or death by initial antihypertensive class. In supplementary analyses we used marginal structural modeling to account for time-updated antihypertensive class and confounding. Results: Among 8041 PWH with hypertension, 24% were initiated on angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker (ACEi/ARB) monotherapy, 23% on thiazide/thiazide-like diuretic monotherapy, 13% on β-blocker monotherapy, and 11% on calcium channel blocker (CCB) monotherapy. Median (IQR) follow-up was 6.5 (3.2-10.5) years and 25% experienced a CVD event. In propensity score-matched analyses, β-blockers, but not CCBs or thiazide/thiazide-like diuretics, were associated with an increased risk of 1) CVD or death 2)incident CVD or death and 3)incident CVD compared with ACEs/ARBs (Incident CVD: HR [95% CI] β-blockers 1.90 [1.24, 2.89]; CCBs 1.02 [0.77, 1.34]; diuretics 1.06 [0.86,1.31]; Figure) . Similar risks were associated with β-blockers in time-updated analyses. In veterans without CKD, initial ACEi/ARB use carried a lower risk of incident heart failure compared with all other classes. Conclusions: We observed high rates of CVD events in PWH with hypertension, and a high prevalence of β-blocker use for initial hypertension management, even among those without indications. Our findings highlight the potential harm associated with β-blockers and the possible benefit associated with ACEI/ARBs for hypertension management in PWH.

Long-term Risk of Heart Failure and Other Adverse Cardiovascular Outcomes in Granulomatosis With Polyangiitis: a Nationwide Cohort Study

2021 ◽  
pp. jrheum.210677
Author(s):  
Guoli Sun ◽  
Adelina Yafasova ◽  
Bo Baslund ◽  
Mikkel Faurschou ◽  
Morten Schou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Granulomatosis With Polyangiitis ◽  
Cox Regression ◽  
Cardiovascular Outcomes ◽  
Adverse Outcomes ◽  
First Year ◽  
Background Population ◽  
Landmark Analyses

Objective To examine the long-term rates of heart failure and other adverse cardiovascular outcomes in a nationwide cohort of patients diagnosed with granulomatosis with polyangiitis (GPA) compared with the background population. Methods Using Danish nationwide registries, patients with first-time diagnosed GPA were identified and matched 1:4 by age, sex, and comorbidities with subjects from background population. Outcomes were compared using Cox regression. Due to violation of the proportional hazard assumption, landmark analyses for the first year and from one year were performed. Results Of the 1,923 patients with GPA, 1,781 patients (median age 59 years, 47.9% men) were matched with 7,124 subjects from the background population. The median follow-up was 6.4 years. The absolute 10-year risk of HF was 6.8% (95%CI, 5.5-8.2%) for GPA patients and 5.9% (5.3-6.6%) for the background population. During the first year after diagnosis, GPA was associated with a significantly higher rate of HF (HR 3.60 [95%CI, 2.28-5.67]) and other adverse outcomes, including atrial fibrillation/flutter (HR 6.50 [4.43-9.55]) and ischemic stroke (HR 3.24 [1.92-5.48]), compared with the background population. After the first year, GPA was not associated with higher rates of HF or other cardiovascular outcomes than the background population, except atrial fibrillation/flutter (HR 1.38 [1.12-1.70]). Conclusion During the first year after diagnosis, the rates of HF and other cardiovascular outcomes were higher in patients with GPA compared with the background population. However, after the first year, the rates of HF and other cardiovascular outcomes, except atrial fibrillation/flutter, were similar to those in the background population.

scholarly journals Association of Sedentary Time and Incident Heart Failure Hospitalization in Postmenopausal Women

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Michael J. LaMonte ◽  
Joseph C. Larson ◽  
JoAnn E. Manson ◽  
John Bellettiere ◽  
Cora E. Lewis ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Postmenopausal Women ◽  
Cox Regression ◽  
Coronary Revascularization ◽  
Sitting Time ◽  
Time Varying ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Race Ethnicity

Background: The 2018 US Physical Activity Guidelines recommend reducing sedentary behavior (SB) for cardiovascular health. SB’s role in heart failure (HF) is unclear. Methods: We studied 80 982 women in the Women’s Health Initiative Observational Study, aged 50 to 79 years, who were without known HF and reported ability to walk ≥1 block unassisted at baseline. Mean follow-up was 9 years for physician-adjudicated incident HF hospitalization (1402 cases). SB was assessed repeatedly by questionnaire. Time-varying total SB was categorized according to awake time spent sitting or lying down (≤6.5, 6.6–9.5, >9.5 h/d); sitting time (≤4.5, 4.6–8.5, >8.5 h/d) was also evaluated. Hazard ratios and 95% CI were estimated using Cox regression. Results: Controlling for age, race/ethnicity, education, income, smoking, alcohol, menopausal hormone therapy, and hysterectomy status, higher HF risk was observed across incremental tertiles of time-varying total SB (hazard ratios [95% CI], 1.00 [referent], 1.15 [1.01–1.31], 1.42 [1.25–1.61], trend P <0.001) and sitting time (1.00 [referent], 1.14 [1.01–1.28], 1.54 [1.34–1.78], trend P <0.001). The inverse trends remained significant after further controlling for comorbidities including time-varying myocardial infarction and coronary revascularization (hazard ratios: SB, 1.00, 1.11, 1.27; sitting, 1.00, 1.09, 1.37, trend P <0.001 each) and for baseline physical activity (hazard ratios: SB 1.00, 1.10, 1.24; sitting 1.00, 1.08, 1.33, trend P <0.001 each). Associations with SB exposures were not different according to categories of baseline age, race/ethnicity, body mass index, physical activity, physical functioning, diabetes, hypertension, or coronary heart disease. Conclusions: SB was associated with increased risk of incident HF hospitalization in postmenopausal women. Targeted efforts to reduce SB could enhance HF prevention in later life.

The impact of statin therapy after surgical or endovascular treatment of cerebral aneurysms

2020 ◽  
Vol 133 (1) ◽  
pp. 182-189
Author(s):  
Tae-Jin Song ◽  
Seung-Hun Oh ◽  
Jinkwon Kim
Keyword(s):  
Statin Therapy ◽  
Coil Embolization ◽  
Primary Outcome ◽  
Cox Regression ◽  
Cerebral Aneurysms ◽  
Time Dependent ◽  
Lipid Lowering ◽  
Surgical Clipping ◽  
The Impact

OBJECTIVECerebral aneurysms represent the most common cause of spontaneous subarachnoid hemorrhage. Statins are lipid-lowering agents that may expert multiple pleiotropic vascular protective effects. The authors hypothesized that statin therapy after coil embolization or surgical clipping of cerebral aneurysms might improve clinical outcomes.METHODSThis was a retrospective cohort study using the National Health Insurance Service–National Sample Cohort Database in Korea. Patients who underwent coil embolization or surgical clipping for cerebral aneurysm between 2002 and 2013 were included. Based on prescription claims, the authors calculated the proportion of days covered (PDC) by statins during follow-up as a marker of statin therapy. The primary outcome was a composite of the development of stroke, myocardial infarction, and all-cause death. Multivariate time-dependent Cox regression analyses were performed.RESULTSA total of 1381 patients who underwent coil embolization (n = 542) or surgical clipping (n = 839) of cerebral aneurysms were included in this study. During the mean (± SD) follow-up period of 3.83 ± 3.35 years, 335 (24.3%) patients experienced the primary outcome. Adjustments were performed for sex, age (as a continuous variable), treatment modality, aneurysm rupture status (ruptured or unruptured aneurysm), hypertension, diabetes mellitus, household income level, and prior history of ischemic stroke or intracerebral hemorrhage as time-independent variables and statin therapy during follow-up as a time-dependent variable. Consistent statin therapy (PDC > 80%) was significantly associated with a lower risk of the primary outcome (adjusted hazard ratio 0.34, 95% CI 0.14–0.85).CONCLUSIONSConsistent statin therapy was significantly associated with better prognosis after coil embolization or surgical clipping of cerebral aneurysms.

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