The objective of this study was to analyse persistence to lipid-lowering drug use for primary prevention of cardiovascular disease (CVD) in a new users cohort, to explore all-cause and cardiovascular related morbidity, comorbidity and mortality in this group and, finally, to study the relationship between persistence and morbimortality. We selected subjects who started lipid-lowering treatment for primary prevention of CVD between 1 January 2010 and 31 December 2017 (N = 1424), and classified them as treatment-persistent or -nonpersistent. Bivariate analyses were performed to compare sociodemographic and clinical variables, morbimortality and time to event between groups. The association between morbidities was explored using comorbidity network analysis. The effect of persistence was analysed using logistic regression and Cox survival analyses. Only 38.7% of users were persistent with treatment. Persistent and nonpersistent users had similar sociodemographic and clinical profiles, although differed in age, smoking status, and glycemia. Comorbidity networks revealed that the number of co-occurring diagnoses was higher in nonpersistent than persistent users. Adjusted analyses indicated a protective effect of treatment persistence, especially against major adverse cardiovascular events (MACE), but this effect was not statistically significant. Observational studies are crucial to characterize real-world effectiveness.

中文翻译：

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用于心血管疾病一级预防的降血脂药物新男性使用者：治疗持久性对死亡率的影响：一项纵向研究

这项研究的目的是分析一个新的使用者队列中降脂药物在心血管疾病（CVD）一级预防中的持久性，探讨该人群中与全因和心血管相关的发病率，合并症和死亡率，最后，研究持久性和死亡率之间的关系。我们选择了在2010年1月1日至2017年12月31日期间开始进行脂质降低治疗以进行CVD的一级预防的受试者（N = 1424），并将其分类为治疗持久性或非持久性。进行双变量分析以比较两组之间的社会人口统计学和临床​​变量，死亡率和事件发生时间。使用合并症网络分析探索了发病率之间的关联。使用logistic回归和Cox生存分析分析了持久性的影响。只有38.7％的使用者坚持治疗。永久性和非永久性使用者具有相似的社会人口统计学和临床​​特征，尽管年龄，吸烟状况和血糖水平不同。合并症网络显示，非持久性用户的并发诊断次数高于持久性用户。调整后的分析表明治疗持续存在保护作用，尤其是对重大心血管不良事件（MACE）的保护作用，但这种作用在统计学上不显着。观察研究对于表征现实世界的有效性至关重要。合并症网络显示，非持久性用户的并发诊断次数高于持久性用户。调整后的分析表明治疗持续存在保护作用，尤其是对重大心血管不良事件（MACE）的保护作用，但这种作用在统计学上不显着。观察研究对于表征现实世界的有效性至关重要。合并症网络显示，非持久性用户的并发诊断次数高于持久性用户。调整后的分析表明治疗持续存在保护作用，尤其是对重大心血管不良事件（MACE）的保护作用，但这种作用在统计学上不显着。观察研究对于表征现实世界的有效性至关重要。