Abstract
Background
In current literature the association between statin use and cataracts is inconsistent
and controversial. We sought to further examine the effect of statin use on the risk
of cataract and need for surgical intervention in 2 North American populations.
Methods
This retrospective nested case-control study derived data from the British Columbia
(BC) Ministry of Health databases from 2000-2007 and the IMS LifeLink database from
2001-2011 to form 2 patient cohorts. The BC cohort was comprised of female and male
patients; 162,501 patients were matched with 650,004 control subjects. The IMS LifeLink
cohort was comprised of male patients aged 40-85 years; 45,065 patients were matched
with 450,650 control subjects. Patients with statin use for > 1 year before the initial
ophthalmology visit were identified. Diagnosis and surgical management of cataract
were followed. Conditional logistic regression models were used to analyze data.
Results
For the BC cohort, the crude rate ratio (RR) for use of any statin was 1.30, and the
adjusted RR was 1.27 (95% confidence interval, 1.24-1.30). The adjusted RRs for each
individual statin were all statistically significant. For the IMS LifeLink cohort,
the crude RR for use of any statin was 1.13, and the adjusted RR was 1.07 (95% confidence
interval, 1.04-1.10).
Conclusions
This study demonstrates that statin use is significantly associated with cataract
requiring surgical intervention. This relationship was consistent in both North American
cohorts. Further assessment of this relationship is recommended, especially because
of increased statin use and the importance of acceptable vision in old age when cardiovascular
disease is common.
Résumé
Introduction
Dans la littérature actuelle, le lien entre l'utilisation des statines et les cataractes
est contradictoire et controversé. Nous avons cherché à examiner davantage l'effet
de l'utilisation des statines sur le risque de cataractes et la nécessité de l'intervention
chirurgicale dans 2 populations nord-américaines.
Méthodes
Les données de cette étude de type cas-témoins imbriquée dans une cohorte rétrospective
provenaient des bases de données du ministère de la Santé de la Colombie-Britannique
(C.-B.) de 2000 à 2007 et de la base de données du IMS LifeLink de 2001 à 2011 pour
former 2 cohortes de patients. La cohorte de la C.-B. comprenait des patients de sexe
féminin et de sexe masculin; 162 501 patients ont été appariés à 650 004 témoins.
La cohorte de la IMS LifeLink comprenait des hommes de 40 à 85 ans; 45 065 patients
ont été appariés à 450 650 témoins. Nous avons déterminé les patients qui utilisaient
les statines depuis > 1 an avant la visite initiale en ophtalmologie. Nous avons fait
le suivi du diagnostic et de la prise en charge chirurgicale des cataractes. Nous
avons utilisé des modèles de régression logistique conditionnelle pour analyser les
données.
Résultats
En ce qui concerne la cohorte de la C.-B., le taux brut (TB) de l'utilisation de toute
statine était de 1,30 et le TB ajusté était de 1,27 (intervalle de confiance à 95
%, 1,24-1,30). Les TB ajustés de chacune des statines étaient tous statistiquement
significatifs. Pour ce qui est de la cohorte de la IMS LifeLink, le TB de l'utilisation
de toutes les statines était de 1,13 et le TB ajusté était de 1,07 (intervalle de
confiance à 95 %, 1,04-1,10).
Conclusions
Cette étude démontre que l'utilisation des statines est associée de manière significative
à des cataractes nécessitant une intervention chirurgicale. Ce lien était cohérent
dans les deux cohortes nord-américaines. D'autres évaluations sur ce lien sont recommandées,
particulièrement en raison de l'augmentation de l'utilisation des statines et de l'importance
d'avoir une vision acceptable au cours de la vieillesse, soit à cette période où la
maladie cardiovasculaire est commune.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Canadian Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Global data on visual impairment in the year 2002.Bull World Health Organ. 2004; 82: 844-851
- Trends in cost of major eye disease to Medicare, 1991 to 2000.Am J Ophthalmol. 2006; 142: 976-982
- Human cholesterol metabolism and therapeutic molecules.Exp Physiol. 2008; 93: 27-42
- Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomized trials.Lancet. 2010; 376: 1670-1681
- Statins for the primary prevention of cardiovascular disease.Cochrane Database Syst Rev. 2013; 1: CD004816
- On the etiology of subcapsular lenticular opacities produced in dogs receiving HMG-CoA reductase inhibitors.Exp Eye Res. 1990; 50: 65-78
- Unintended effects of statin in men and women in England and Wales: population based cohort study using the QResearch database.BMJ. 2010; 340: c2197
- Age-related cataract is associated with type 2 diabetes and statin use.Optom Vis Sci. 2012; 89: 1165-1171
- Association of statin use with cataracts: a propensity score-matched analysis.JAMA. 2013; 131: 1427-1434
- Statin use and cataract surgery: a nationwide retrospective cohort study in elderly ethnic Chinese patients.Drug Saf. 2013; 36: 1017-1024
- Absence of effect of simvastatin on the progression of lens opacities in a randomized placebo controlled study.Br J Ophthalmol. 1995; 79: 996-1002
- Cataract and the use of statins: a case-control study.Q J Med. 2003; 96: 337-343
- Risk of cataract in patients treated with statins.Arch Intern Med. 2001; 161: 2021-2026
- MF Rousseau. Statin therapy and cataract in type 2 diabetes.Diabetes Metab. 2011; 37: 139-143
- Persistence with statins and incident cataract: a population based historical cohort study.Ann Epidemiol. 2010; 20: 136-142
- Statin use and incident nuclear cataract.JAMA. 2006; 295: 2752-2758
- Statin use and the long term risk of incident cataract: the Blue Mountains eye study.Am J Ophthalmol. 2007; 143: 687-689
- Recent statin use and cataract surgery.Am J Ophthalmol. 2012; 153: 222-228
Population Data BC. Discharge Abstracts Database (Hospital Separations file). Availbable at: http://www.popdata.bc.ca/data/internal/health/dad. Accessed June 23, 2013.
British Columbia Ministry of Health. Medical Services Plan of B.C. Available at: http://www.health.gov.bc.ca/msp/index.html. Accessed June 23, 2013.
British Columbia Ministry of Health. PharmaNet. Available at: http://www.health.gov.bc.ca/pharmacare/pharmanet/netindex.html. Accessed June 23, 2013.
- Risk of death in elderly users of conventional vs. atypical antipsychotic medications.N Engl J Med. 2005; 353: 2335-2341
- Oral fluoroquinolones and the risk of retinal detachment.JAMA. 2012; 307: 1414-1419
- The nested case-control study in cardiology.Am Heart J. 2003; 146: 581-590
- Withdrawal of cerivastatin from the world market.Curr Control Trials Cardiovasc Med. 2001; 2: 205-207
- Lanosterol synthase mutations cause cholesterol deficiency-associated cataracts in the shumiya cataract rat.J Clin Invest. 2006; 116: 395-404
- Cholesterol and cataracts.Surv Ophthalmol. 1996; 40: 320-337
- Clinical Ophthalmology: A Systematic Approach.7th Ed. Elsevier, Philadelphia2011
- Statin adverse effects: a review of the literature and evidence for a mitochondrial mechanism.Am J Cardiovasc Drugs. 2008; 8: 373-418
- Canadian Ophthalmological Society evidence-based clinical practice guidelines for cataract surgery in the adult eye.Can J Ophthalmol. 2008; 43: S7-57
Article Info
Publication History
Accepted:
August 18,
2014
Received:
May 24,
2014
Footnotes
See editorial by Gryn et al., pages 1508-1510 in this issue.
See page 1618 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Statins and Cataracts: Reverse Causality?Canadian Journal of CardiologyVol. 31Issue 5
- PreviewThe report of Wise et al.,1 on increased risk of cataracts among patients who receive statins, is burdened by the risk of reverse causality inherent in such observational studies. Perhaps the best known example of this problem is the report from a US Health Cooperative, (see Supplemental Reference S1) that patients taking calcium channel antagonists had a greater risk of myocardial infarction, leading to an enormous tempest in a teapot. This fiasco was finally understood when it became apparent that the patients were receiving calcium channel antagonists for angina.
- Full-Text
- Preview
