Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease

Background: Statin therapy is recommended for secondary prevention of atherosclerotic vascular disease (ASCVD) based on randomized trials, which enrolled mostly men with coronary artery disease (CAD), whereas women and patients with cerebrovascular (CVD) and peripheral artery disease (PAD) were unde...

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Main Authors: Gregor Verček, Tjaša Furlan, Dalibor Gavrić, Mitja Lainščak, Jerneja Farkaš Lainščak, Irena Ograjenšek, Petra Došenović Bonča, Borut Jug
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Cardiology. Cardiovascular Risk and Prevention
Online Access:http://www.sciencedirect.com/science/article/pii/S2772487525000534
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author Gregor Verček
Tjaša Furlan
Dalibor Gavrić
Mitja Lainščak
Jerneja Farkaš Lainščak
Irena Ograjenšek
Petra Došenović Bonča
Borut Jug
author_facet Gregor Verček
Tjaša Furlan
Dalibor Gavrić
Mitja Lainščak
Jerneja Farkaš Lainščak
Irena Ograjenšek
Petra Došenović Bonča
Borut Jug
author_sort Gregor Verček
collection DOAJ
description Background: Statin therapy is recommended for secondary prevention of atherosclerotic vascular disease (ASCVD) based on randomized trials, which enrolled mostly men with coronary artery disease (CAD), whereas women and patients with cerebrovascular (CVD) and peripheral artery disease (PAD) were under-represented. We analyzed the effectiveness of statin therapy uptake in a nation-wide cohort of women hospitalized for ASCVD. Methods: Women hospitalized for CAD, CVD, or PAD, including aortic disease, between 2015 and 2021 were retrospectively identified by linking the national hospital database, medicines reimbursement claims, and national mortality registry. The association of statin uptake within 30 days post-discharge with clinical outcomes (all-cause mortality and cardiovascular hospitalizations) was assessed by Kaplan-Meier curves and Cox proportional hazards regression model with propensity score-derived inverse probability of treatment weights and a 30-day landmark period. Results: We included 24,665 women with ASCVD – 14,419 with CAD, 5,427 with CVD, and 4,819 with PAD. Overall, the median age was 73 (64–81) years. The rates of statin uptake were 50 % for women with CAD, 60 % for CVD and 28 % for PAD. Statin therapy uptake was associated with a reduction in all-cause mortality and cardiovascular hospitalizations across all three major types of ASCVD: hazard ratio (HR) 0.88, 95 % confidence interval (CI) 0.83–0.93, p = 0.001 for CAD, HR 0.87, 95 % CI 0.80–0.94, p = 0.006 for PAD, and HR 0.72, 95 % CI 0.66–0.78, p < 0.001 for CVD. Conclusion: Statin therapy is associated with reduced all-cause mortality and cardiovascular hospital readmissions in women with all major types of ASCVD.
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spelling doaj-art-5f6ffa7da00b4192ae5ef30ab4b26a6b2025-08-20T03:10:21ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752025-06-012520041510.1016/j.ijcrp.2025.200415Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery diseaseGregor Verček0Tjaša Furlan1Dalibor Gavrić2Mitja Lainščak3Jerneja Farkaš Lainščak4Irena Ograjenšek5Petra Došenović Bonča6Borut Jug7Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia; Corresponding author. Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloska 7/VI, SI-1000, Ljubljana, Slovenia.General Hospital Trbovlje, Trbovlje, SloveniaThe Health Insurance Institute of Slovenia, Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; General Hospital Murska Sobota, Murska Sobota, SloveniaGeneral Hospital Murska Sobota, Murska Sobota, Slovenia; National Institute of Public Health, Ljubljana, SloveniaSchool of Economics and Business, University of Ljubljana, Ljubljana, SloveniaSchool of Economics and Business, University of Ljubljana, Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, SloveniaBackground: Statin therapy is recommended for secondary prevention of atherosclerotic vascular disease (ASCVD) based on randomized trials, which enrolled mostly men with coronary artery disease (CAD), whereas women and patients with cerebrovascular (CVD) and peripheral artery disease (PAD) were under-represented. We analyzed the effectiveness of statin therapy uptake in a nation-wide cohort of women hospitalized for ASCVD. Methods: Women hospitalized for CAD, CVD, or PAD, including aortic disease, between 2015 and 2021 were retrospectively identified by linking the national hospital database, medicines reimbursement claims, and national mortality registry. The association of statin uptake within 30 days post-discharge with clinical outcomes (all-cause mortality and cardiovascular hospitalizations) was assessed by Kaplan-Meier curves and Cox proportional hazards regression model with propensity score-derived inverse probability of treatment weights and a 30-day landmark period. Results: We included 24,665 women with ASCVD – 14,419 with CAD, 5,427 with CVD, and 4,819 with PAD. Overall, the median age was 73 (64–81) years. The rates of statin uptake were 50 % for women with CAD, 60 % for CVD and 28 % for PAD. Statin therapy uptake was associated with a reduction in all-cause mortality and cardiovascular hospitalizations across all three major types of ASCVD: hazard ratio (HR) 0.88, 95 % confidence interval (CI) 0.83–0.93, p = 0.001 for CAD, HR 0.87, 95 % CI 0.80–0.94, p = 0.006 for PAD, and HR 0.72, 95 % CI 0.66–0.78, p < 0.001 for CVD. Conclusion: Statin therapy is associated with reduced all-cause mortality and cardiovascular hospital readmissions in women with all major types of ASCVD.http://www.sciencedirect.com/science/article/pii/S2772487525000534
spellingShingle Gregor Verček
Tjaša Furlan
Dalibor Gavrić
Mitja Lainščak
Jerneja Farkaš Lainščak
Irena Ograjenšek
Petra Došenović Bonča
Borut Jug
Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease
International Journal of Cardiology. Cardiovascular Risk and Prevention
title Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease
title_full Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease
title_fullStr Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease
title_full_unstemmed Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease
title_short Statins for secondary prevention in women with atherosclerotic vascular disease: A nation-wide analysis of 24,665 women hospitalized for coronary, cerebrovascular or peripheral artery disease
title_sort statins for secondary prevention in women with atherosclerotic vascular disease a nation wide analysis of 24 665 women hospitalized for coronary cerebrovascular or peripheral artery disease
url http://www.sciencedirect.com/science/article/pii/S2772487525000534
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