Association between low-dose @entity117 reinitiation and the risk of XXXX or @entity301 .

@entity1 @entity301 @entity117 @entity583 @entity7943
BACKGROUND: In secondary cardiovascular prevention, discontinuation of @entity117 ( @entity7943 ) is associated with an increased risk of cardiovascular events. This study assessed the impact of @entity7943 reinitiation on the risk of @entity583 and @entity301 . METHODS: @entity1 prescribed @entity7943 for secondary cardiovascular prevention and who had had a period of @entity7943 discontinuation of >= 90 days in 2000-2007 were identified from The Health Improvement Network (N   =   10,453). Incidence of @entity583 / @entity301 was calculated. Survival analyses using adjusted Cox proportional hazard models were performed to calculate hazard ratios and 95% confidence intervals for the risk of @entity583 / @entity301 associated with @entity7943 use patterns after the initial period of discontinuation. Individuals who were prescribed @entity7943 during follow-up were considered reinitiators. RESULTS: The incidence of @entity583 / @entity301 was 8.90 cases per 1000 @entity1 -years. Risk of @entity583 / @entity301 was similar for current @entity7943 users, who had been continuously exposed since reinitiation, and @entity1 who had not reinitiated @entity7943 (hazard ratio 1.27, 95% confidence interval 0.93-1.73). Among reinitiators, an additional period of @entity7943 discontinuation was associated with increased risk of @entity583 / @entity301 compared with no reinitiation (current users: hazard ratio 1.46, 95% confidence interval 1.13-1.90; noncurrent users: hazard ratio 1.70, 95% confidence interval 1.31-2.21). CONCLUSIONS: @entity7943 reinitiation was not associated with a decreased risk of @entity583 / @entity301 . This may be explained by confounding by indication/comorbidity, whereby higher-risk @entity1 are more likely to reinitiate therapy. An additional period of @entity7943 discontinuation among reinitiators was associated with an increased risk of @entity583 / @entity301 .
