Increased risk of @entity64 after discontinuation of XXXX : a UK primary care study.

@entity1 @entity4736 @entity64 @entity66 @entity63 @entity117 @entity4905 @entity955 @entity1281 @entity65 @entity385
OBJECTIVES: Discontinuation of low-dose @entity117 ( @entity1281 ) therapy may increase the risk of @entity63 events. This study evaluated the risk of @entity385 ( @entity385 ) and @entity4905 after low-dose @entity1281 discontinuation in @entity1 with @entity65 or @entity66 . METHODS: The Health Improvement Network UK primary care database was used to identify a cohort of individuals aged 50-84 years with a first prescription for low-dose @entity1281 (75-300 mg/day) for the secondary prevention of cardiovascular or cerebrovascular events in 2000-2007 (n = 39,512). Individuals were followed up for a mean of 3.4 years to identify cases of @entity385 / @entity4905 . Nested case-control analyses were used to assess risk factors for @entity385 / @entity4905 , including low-dose @entity1281 discontinuation. RESULTS: The overall incidence of @entity385 / @entity4905 was 5.0 per 1,000 @entity1 -years (95% confidence interval [CI] 4.6-5.4). @entity385 / @entity4905 was significantly more common in @entity1 with a previous diagnosis of @entity66 (relative risk [RR] 2.79; 95% CI 2.05-3.80) or @entity955 ( @entity4736 .71; 95% CI 1.28-2.29) than in those without these conditions. Compared with current users of low-dose @entity1281 , those who discontinued treatment 31-180 days before the index date had a significantly increased overall risk of @entity385 / @entity4905 ( @entity4736 .40; 95% CI 1.03-1.92). The most common reason for discontinuation was @entity1 nonadherence. CONCLUSION: In @entity1 prescribed low-dose @entity1281 for the secondary prevention of cardiovascular or cerebrovascular events, discontinuation of low-dose @entity1281 was associated with a 40% increase in the risk of @entity385 / @entity4905 compared with continuation of therapy. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that discontinuation of low-dose @entity1281 is associated with a 40% increased risk of @entity64 within 31-180 days of discontinuation.
