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Banca de DEFESA: ALINE FERNANDES PEDROSO CAMARGOS

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : ALINE FERNANDES PEDROSO CAMARGOS
DATE: 08/04/2024
TIME: 09:00
LOCAL: Videoconferência
TITLE:

Statins and Cardiovascular Health in Brazil: Exploring Musculoskeletal Adverse Events, Racial Disparities, and Performance of Risk Stratification Tools

KEY WORDS:

Em breve

PAGES: 109
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

We conducted three studies using data from the Brazilian Longitudinal Study of Adult

Health (ELSA-Brasil), aiming to investigate different aspects related to cardiovascular

diseases (CVD) and statin use in a highly diverse sample of Brazilian public servants.

The first study examined the association between statins and muscle problems, the

second study assessed the performance of internationally recognized CVD risk scores,

and the third study investigated racial disparities in statin use and CVD mortality.

Methods: In the first study, we conducted a cross-sectional analysis of the

musculoskeletal (MSK) cohort of ELSA-Brasil to investigate the association between

statin use and muscle pain or weakness. The second study evaluated the discrimination

and calibration of 5 contemporary cardiovascular risk scores including Framingham

General Risk (FGR), Pooled Cohort Equations (PCE), World Health Organization

(WHO) score, Globorisk-LAC, and SCORE2. We assessed discrimination using the

area under the ROC curve (AUC) and calibration with predicted-to-observed risk ratios

(P/O). In the third study, we performed causal mediation analysis using inverse odds

weighting to explore the mediation effects of socioeconomic status (SES),

cardiovascular risk factors, and statin underutilization on the association between race

and CVD mortality.

Results: We found no statistically significant association between statin use and overall

muscle problems, although a secondary analysis revealed an association between

atorvastatin use and muscle weakness as measured by the repeated sit-to-stand test. We

observed that CVD risk scores tend to overestimate risk and inadequately define risk for

certain demographic groups in Brazil. The results of the third study showed racial

disparities in statin use and CVD mortality, with Black individuals facing higher

mortality risk and lower likelihood of receiving guideline-recommended statin therapy

compared to White individuals.

Conclusion: The first study challenges the previous notion of an efficacy-effectiveness

gap in statins muscular adverse events, indicating that their use does not contribute to

overall muscle problems. The combined findings of three studies underscore the need

for risk stratification strategies and interventions tailored to the specific populations and

risks of the Brazilian population, as well as public health policies addressing racial and

socioeconomic disparities in the prevention and treatment of CVD.

BANKING MEMBERS:
Externa à Instituição - FLÁVIA BULEGON PILECCO - UFMG
Externa à Instituição - GABRIELA MIANA DE MATTOS PAIXÃO - UFMG
Externa à Instituição - ISABELLA VIANA GOMES SCHETTINI
Presidente - 2059540 - ROBERTA CARVALHO DE FIGUEIREDO
Externo à Instituição - SOTERO SERRATE MENGUE - UFRGS

Notícia cadastrada em: 27/03/2024 12:02