Effects of statins on the risks of ischemic stroke and heart disease in human immunodeficiency virus infection, influenza and severe acute respiratory syndrome-associated coronavirus: respiratory virus infection with steroid use

Postgrad Med. 2022 Aug;134(6):589-597. doi: 10.1080/00325481.2022.2080359. Epub 2022 May 26.

Abstract

Objectives: We sought to fill the research gap on the effects of statins on the risks of ischemic stroke and heart disease among individuals with human immunodeficiency virus infection, influenza, and severe acute respiratory syndrome associated-coronavirus (HIS) disorders.

Methods: We enrolled a HIS cohort treated with statins (n = 4921) and a HIS cohort not treated with statins (n = 4921). The cumulative incidence of ischemic stroke and heart disease was analyzed using a time-dependent Cox proportional regression analysis. We analyzed the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of ischemic stroke and heart disease for statins users relative to nonusers based on sex, age, comorbidities and medications.

Results: The aHR (95% CI) was 0.38 (0.22-0.65) for ischemic stroke. The aHR (95% CI) of heart disease was 0.50 (0.46-0.55). The aHRs (95% CI) of statin users with low, medium, and high adherence (statin use covering <33%, 33%-66%, and >66%, respectively, of the study period) for the risks of ischemic stroke were 0.50 (0.27-0.92), 0.31 (0.10-1.01), and 0.16 (0.04-0.68) and for heart disease were 0.56 (0.51-0.61), 0.40 (0.33-0.48), and 0.44 (0.38-0.51), respectively, compared with statin nonusers.

Conclusion: Statin use was associated with lower aHRs for ischemic stroke and heart disease in those with HIS disorders with comorbidities.

Keywords: Ischemic stroke; coronavirus; heart disease; human immunodeficiency virus; influenza.

MeSH terms

  • Coronavirus*
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Heart Diseases*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Influenza, Human* / complications
  • Influenza, Human* / drug therapy
  • Influenza, Human* / epidemiology
  • Ischemic Stroke* / epidemiology
  • Retrospective Studies
  • Steroids / therapeutic use
  • Stroke* / complications
  • Stroke* / epidemiology

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Steroids