The risk of stroke according to statin medication compliance in older people with chronic periodontitis: an analysis using the Korea National Health Insurance Service-Senior Cohort Database
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OBJECTIVES: We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis. METHODS: Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final number of patients in the BSG and TSG was 6,172 each. To analyze the risk of stroke, a Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for age, sex, income level, hypertension, diabetes, and Charlson comorbidity index. RESULTS: In the Kaplan-Meier curve, the disease-free probability was prominently lower in the BSG than in the TSG (p for log-rank= 0.001). The HR in the multivariable-adjusted model for stroke occurrence in the TSG compared to the BSG was 0.79 (95% CI, 0.67 to 0.92; p= 0.002). Subgroup analyses showed significant associations between compliance to statin medication and stroke, especially in female, people 85 years or older, and patients with comorbidities. CONCLUSIONS: Increasing compliance to statins may reduce stroke risk in older adults with chronic periodontitis. Therefore, in order to increase medication compliance among older people with chronic periodontitis, it is necessary for medical staff to make efforts to provide effective medication guidance.
Abstract
OBJECTIVES: We investigated the risk of stroke according to statin medication compliance in older people with chronic periodontitis. METHODS: Chronic periodontitis patients were extracted from the National Health Insurance Service-Senior Cohort Database from 2002 to 2014. Among 255,056 chronic periodontitis patients, 41,412 patients with statin prescriptions for 28 days or more were included. The study population was divided into the top 25% of medication compliance group (TSG) and the lower 25% of medication compliance group (BSG). After 1:1 propensity score matching was performed, the final number of patients in the BSG and TSG was 6,172 each. To analyze the risk of stroke, a Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) after adjusting for age, sex, income level, hypertension, diabetes, and Charlson comorbidity index. RESULTS: In the Kaplan-Meier curve, the disease-free probability was prominently lower in the BSG than in the TSG (p for log-rank= 0.001). The HR in the multivariable-adjusted model for stroke occurrence in the TSG compared to the BSG was 0.79 (95% CI, 0.67 to 0.92; p= 0.002). Subgroup analyses showed significant associations between compliance to statin medication and stroke, especially in female, people 85 years or older, and patients with comorbidities. CONCLUSIONS: Increasing compliance to statins may reduce stroke risk in older adults with chronic periodontitis. Therefore, in order to increase medication compliance among older people with chronic periodontitis, it is necessary for medical staff to make efforts to provide effective medication guidance.
참고문헌 (46)
- Pihlstrom BL, "Periodontal diseases", Lancet, 366, pp.1809~1820 (2005)
- Nazir MA, "Prevalence of periodontal disease, its association with systemic diseases and prevention", Int J Health Sci(Qassim), 11, pp.72~80 (2017)
- Korean Dental Association, "2019 Year book of the Korea dentistry", pp.9~ (2020), Korean Dental Association
- Vidal F, "Non-surgical periodontal treatment reduces cardiovascular risk in refractory hypertensive patients : a pilot study", J Clin Periodontol, 40, pp.681~687 (2013)
- Vergnes JN, "The effects of periodontal treatment on diabetic patients : the DIAPERIO randomized controlled trial", J Clin Periodontol, 45, pp.1150~1163 (2018)
- Bertl K, "The effect of local and systemic statin use as an adjunct to non-surgical and surgical periodontal therapy : a systematic review and meta-analysis", J Dent, 67, pp.18~28 (2017)
- Committee for Guidelines for Management of Dyslipidemia, "2015 Korean guidelines for management of dyslipidemia", J Lipid Atheroscler, 4, pp.61~92 (2015)
- Cicek Ari V, "Statins and IL-1β, IL-10, and MPO levels in gingival crevicular fluid : preliminary results", Inflammation, 39, pp.1547~1557 (2016)
- Sakoda K, "Simvastatin decreases IL-6 and IL-8 production in epithelial cells", J Dent Res, 85, pp.520~523 (2006)
- Thangamani S, "Exploring simvastatin, an antihyperlipidemic drug, as a potential topical antibacterial agent", Sci Rep, 5, pp.16407~ (2015)
- Mundy G, "Stimulation of bone formation in vitro and in rodents by statins", Science, 286, pp.1946~1949 (1999)
- Jin J, "Simvastatin inhibits LPS-induced alveolar bone loss during metabolic syndrome", J Dent Res, 93, pp.294~299 (2014)
- Bouitbir J, "Statins trigger mitochondrial reactive oxygen species-induced apoptosis in glycolytic skeletal muscle", Antioxid Redox Signal, 24, pp.84~98 (2016)
- Donnan GA, "Stroke", Lancet, 371, pp.1612~1623 (2008)
- Kernan WN, "Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack : a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2014, pp.45, 2160~2236
- Suh I, "Low serum cholesterol and haemorrhagic stroke in men : Korea Medical Insurance Corporation Study", Lancet, 357, pp.922~925 (2001)
- Shahar E, "Plasma lipid profile and incident ischemic stroke : the Atherosclerosis Risk in Communities(ARIC)study", Stroke, 34, pp.623~631 (2003)
- Iso H, "Serum cholesterol levels and six-year mortality from stroke in 350, 977 men screened for the multiple risk factor intervention trial", N Engl J Med, 320, pp.904~910 (1989)
- Osterberg L, "Adherence to medication", N Engl J Med, 353, pp.487~497 (2005)
- Iuga AO, "Adherence and health care costs", Risk Manag Healthc Policy, 7, pp.35~44 (2014)
- Roebuck MC, "Medication adherence leads to lower health care use and costs despite increased drug spending", Health Aff(Millwood), 30, pp.91~99 (2011)
- Korea’s health care through the Korean medical panel (2008-2012), "Seo NG", Korea Institute for Health and Social Affairs, 359~392 (2013)
- Park CM, "Analysis of medical expenses and health outcomes according to treatment continuity : focusing on hypertension and diabetes", Health Insurance Review and Assessment Service, 156~ (2010)
- Kwon S, "Thirty years of national health insurance in South Korea : lessons for achieving universal health care coverage", Health Policy Plan, 24, pp.63~71 (2009)
- Seong SC, "Data resource profile : the national health information database of the National Health Insurance Service in South Korea", Int J Epidemiol, 46, pp.799~800 (2017)
- 홍재석, "우리나라 성인 2형 당뇨환자에서의 외래 투약 순응도와 관련요인 분석", 보건행정학회지, 20(2), pp.128~143 (2010), 한국보건행정학회
- Cramer JA, "Medication compliance and persistence : terminology and definitions", Value Health, 11, pp.44~47 (2008)
- Kim JA, "Impact of visit-to-visit fasting plasma glucose variability on the development of type 2 diabetes : a nationwide population-based cohort study", Diabetes Care, 41, pp.2610~2616 (2018)
- de Groot V, "How to measure comorbidity. a critical review of available methods", J Clin Epidemiol, 56, pp.221~229 (2003)
- 김경훈, "Charlson 동반질환의 ICD-10 알고리즘 예측력 비교연구", 예방의학회지, 43(1), pp.42~49 (2010), 대한예방의학회
- Liccardo D, "Periodontal disease : a risk factor for diabetes and cardiovascular disease", Int J Mol Sci, 20, pp.1414~ (2019)
- Sanz M, "Periodontitis and cardiovascular diseases : consensus report", J Clin Periodontol, 47, pp.268~288 (2020)
- European Stroke Organisation (ESO) Executive Committee, "Guidelines for management of ischaemic stroke and transient ischaemic attack 2008", Cerebrovasc Dis, 25, pp.457~507 (2008)
- Amarenco P, "Lipid management in the prevention of stroke : review and updated meta-analysis of statins for stroke prevention", Lancet Neurol, 8, pp.453~463 (2009)
- Barat I, "Drug therapy in the elderly : what doctors believe and patients actually do", Br J Clin Pharmacol, 51, pp.615~622 (2001)
- 김성옥, "고혈압과 당뇨병 노인의 복약순응도와 이에 영향을 미치는 요인", 한국임상약학회지, 21(2), pp.81~89 (2011), 한국임상약학회
- Cramer JA, "Partial medication compliance : the enigma in poor medical outcomes", Am J Manag Care, 1, pp.167~174 (1995)
- Faught E, "Nonadherence to antiepileptic drugs and increased mortality : findings from the RANSOM Study", Neurology, 71, pp.1572~1578 (2008)
- Reeves MJ, "Sex differences in stroke : epidemiology, clinical presentation, medical care, and outcomes", Lancet Neurol, 7, pp.915~926 (2008)
- Petrea RE, "Gender differences in stroke incidence and poststroke disability in the Framingham heart study", Stroke, 40, pp.1032~1037 (2009)
- Ridker PM, "Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein", N Engl J Med, 359, pp.2195~2207 (2008)
- Mora S, "Statins for the primary prevention of cardiovascular events in women with elevated high-sensitivity C-reactive protein or dyslipidemia : results from the Justification for the Use of Statins in Prevention : an Intervention Trial Evaluating Rosuvastatin(JUPITER)and meta-analysis of women from primary prevention trials", Circulation, 121, pp.1069~1077 (2010)
- D’Agostino RB, "Stroke risk profile: adjustment for antihypertensive medication. The Framingham Study", Stroke, 25, pp.40~43 (1994)
- 정찬희, "Diabetes Fact Sheets in Korea, 2020: An Appraisal of Current Status", Diabetes and Metabolism Journal, 45(1), pp.1~10 (2021), 대한당뇨병학회[DOI]
- Kwon MJ, "Longitudinal follow-up study of the association between statin use and chronic periodontitis using national health screening cohort of Korean population", Sci Rep, 12, pp.5504~ (2022)
- Wilchesky M, "Validation of diagnostic codes within medical services claims", J Clin Epidemiol, 57, pp.131~141 (2004)