mortality data. Study cohort was statin-naïve patients initially prescribed statin therapy from January 2003-July 2011, and registered within the practice for ≥1 year preceding statin initiation. High-dose was defined as simvastatin 80mg, fluvastatin 80mg, atorvastatin>20mg, rosuvastatin>10mg. Adjusted Cox regression models were used to predict factors associated with discontinuation and CV event risk. RESULTS: Only 2% (4,744/218,808) of patients started on a high-dose statin; 4,399/4,744, (93%) on atorvastatin, a third taking atorvastatin 80mg. Adherence was high based on prescribed medication possession ratio for high-(0.96, SD:0.08) and low-dose (0.95, SD:0.10) initiation. Initial dose was not a predictor of discontinuation in the overall population (HR:0.96 95%CI:0.91-1.02), but in patients with CV history, high-dose initiation was associated with lower discontinuation risk (HR:0.87 95%CI 0.78-0.96). In the overall population increased CV event rates were associated with initiation of high-dose statin (
OBJECTIVES: Iron chelators (deferasirox or desferrioxamine) are essential to patients who need life-long blood transfusion (e.g. -Thalassemia). However, in 2010, the US Food and Drug Administration (FDA) had issued a warning on potential adverse events associated with iron chelators, especially deferasirox. The objective of this retrospective cohort study was to compare the risk of renal impairment, hepatic impairment, and gastrointestinal bleeding in patients with transfusiondependent anemia using deferasirox or desferrioxamine. METHODS: Patients with transfusion-dependent anemia (sickle cell disease, -thalassaemia, myelodysplastic syndrome and aplastic anemia) and were prescribed iron chelators (deferasirox or desferrioxamine) were identified from the 2005Ϫ2009 Taiwan's National Health Insurance database. Cox proportional hazards models were used to assess the association between iron chelators and occurrences of adverse events (renal impairment, hepatic impairment, and gastrointestinal bleeding). All models adjusted for age, sex, drug exposure (days), type of transfusion-dependent anemia and medical history. RESULTS: Patients were categorized into deferasirox (nϭ180), desferrioxamine (nϭ586),and mixed users (nϭ202), based on the drug they received during the follow-up. The crude rates of adverse events were 4.14, 3.16 and 0.65 per 10,000 person-year in deferasirox, desferrioxamine and mix users, respectively. After adjusting covariates, there was no association between deferasirox and adverse events (hazard ratio [HR]0.84; 95% CI, 0.59 -2.00) compared to desferrioxamine users. CONCLUSIONS: In this population-based analysis, transfusion-dependant anemia patients using deferasirox and desferrioxamine were at similar risk of adverse events.
OBJECTIVES:To compare clinical outcomes of type 2 diabetic patients with and without TZDs therapy after patients receiving DES. METHODS: We conducted a retrospective cohort study using the National Health Insurance Database (NHIRD). The type 2 diabetes mellitus patients were included if they received first limuseluting stent or paclitaxel-eluting stent placement and were identified by presence of a hospital claim during the period from December 1, 2006, through December 31, 2007. Follow-up data were available through December 31, 2008. Patients were classified into two groups based on the antidiabetic agents they took from pharmacy records for use of TZD (rosiglitazone, pioglitazone) or non-TZD within 3 months after the index date of hospitalization. A total of 1,743 patients who received stents during the study period were identified as the study subjects. Our measure of effectiveness was the prevalence of death, myocardial infarction and repeat revascularization, defined as any PCI, whether or not the patient received a stent, or crossed over to CABG within one year after index hospitalization. RESULTS: There were 268 patients in TZD group, 1,475 patients in non-TZD group. Compared with non-TZD group, there were no significant difference in adjusted hazard ratio of death, myocardial infarction and repeat revascularization between limus-eluting stent group and paclitaxel-eluting stent group. In stratified analysis, patients who received limus-eluting stent with history of myocardial infarction and treated with TZDs were associated with a higher risk of myocardial infarction (HRϭ 5.292,. CONCLUSIONS: Our findings suggest that TZDs could not improve clinical outcomes in type 2 diabetes patients after drug-eluting stent implantation. TZDs may contribute to higher risk of myocardial infarction in patient with limus-eluting stent and history of myocardial infarction. For the pleiotropic effects of TZDs, balance between benefit and risk for cardiovascular events to different subgroups, may be different.Further studies are required to investigate this relationship.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.