title: Statin Safety in Chinese: A Population-Based Study of Older Adults.
abstract: BACKGROUND
  Compared to Caucasians, Chinese achieve a higher blood concentration of statin for a given dose. It remains unknown whether this translates to increased risk of serious statin-associated adverse events amongst Chinese patients.
  
  
  METHODS
  We conducted a population-based retrospective cohort study of older adults (mean age, 74 years) newly prescribed a statin in Ontario, Canada between 2002 and 2013, where 19,033 Chinese (assessed through a validated surname algorithm) were matched (1:3) by propensity score to 57,099 non-Chinese. This study used linked healthcare databases.
  
  
  RESULTS
  The follow-up observation period (mean 1.1, maximum 10.8 years) was similar between groups, as were the reasons for censoring the observation period (end of follow-up, death, or statin discontinuation). Forty-seven percent (47%) of Chinese were initiated on a higher than recommended statin dose. Compared to non-Chinese, Chinese ethnicity did not associate with any of the four serious statin-associated adverse events assessed in this study [rhabdomyolysis hazard ratio (HR) 0.61 (95% CI 0.28 to 1.34), incident diabetes HR 1.02 (95% CI 0.80 to 1.30), acute kidney injury HR 0.90 (95% CI 0.72 to 1.13), or all-cause mortality HR 0.88 (95% CI 0.74 to 1.05)]. Similar results were observed in subgroups defined by statin type and dose.
  
  
  CONCLUSIONS
  We observed no higher risk of serious statin toxicity in Chinese than matched non-Chinese older adults with similar indicators of baseline health. Regulatory agencies should review available data, including findings from our study, to decide if a change in their statin dosing recommendations for people of Chinese ethnicity is warranted.
authors.affiliation: Division of Nephrology, Department of Medicine, Western University, London, Canada.
authors.forename: Daniel Q
authors.initials: DQ
authors.lastname: Li
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, Western University, London, Canada.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Kim
authors.affiliation: Institute for Clinical Evaluative Sciences (ICES) Western, London, Ontario, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: McArthur
authors.affiliation: Division of Nephrology, Department of Medicine, Western University, London, Canada.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Fleet
authors.affiliation: Blackburn Cardiovascular Genetics Laboratory, Robarts Research Institute, University of Western Ontario, London, Ontario, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hegele
authors.affiliation: Institute for Clinical Evaluative Sciences (ICES) Western, London, Ontario, Canada.|Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Baiju R
authors.initials: BR
authors.lastname: Shah
authors.affiliation: Division of Nephrology, Department of Medicine, Western University, London, Canada.|Institute for Clinical Evaluative Sciences (ICES) Western, London, Ontario, Canada.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Weir
authors.affiliation: Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Amber O
authors.initials: AO
authors.lastname: Molnar
authors.affiliation: Institute for Clinical Evaluative Sciences (ICES) Western, London, Ontario, Canada.|Department of Epidemiology and Biostatistics, Western University, London, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dixon
authors.affiliation: Institute for Clinical Evaluative Sciences (ICES) Western, London, Ontario, Canada.|Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Jack V
authors.initials: JV
authors.lastname: Tu
authors.affiliation: Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
authors.forename: Sonia
authors.initials: S
authors.lastname: Anand
authors.affiliation: Division of Nephrology, Department of Medicine, Western University, London, Canada.|Institute for Clinical Evaluative Sciences (ICES) Western, London, Ontario, Canada.
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D008297:Male; D063868:Patient Outcome Assessment; D062486:Public Health Surveillance; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors