Measurements
death, extrahepatic cancer-related, high-density lipoprotein [HDL], liver cancer, cancer, HCC, hypertension, diabetes
CARDIOVASCULAR DISEASES, LIVER CANCER, CANCER, HYPERTENSION, DIABETES
The exposure was statin use. We identified all lipophilic statins (atorvastatin, simvastatin, fluvastatin, lovastatin, and cerivastatin) and hydrophilic statins (rosuvastatin and pravastatin) prescription code in the K-NHIS database after the index visit. We performed an intention to treat analysis. Subjects were assigned into a statin user group if the prescription was at least one day.The primary endpoint was development of HCC during follow-up. HCC was defined as the presence of cancer-specific insurance claim code (V193 code) with a C22.0 code which was an ICD-10 code for HCC. Secondary endpoints were liver cancer or liver-related mortality, defined by presence of C22, B15-19, K70-75 codes in the death certificate, and all-cause mortality. In addition, we defined extrahepatic cancer-related mortality when the cause of mortality was cancer other than liver cancer (C code except for C22). Cardiovascular disease-related mortality was defined when the cause of mortality was cardiovascular diseases by following ICD-10 codes (I69, I63, I62, I61, I60, I50, I48, I46, I35, I34, I26, I25, I21, I20, I11, I10).Vital status and cause of death were obtained from death certification collected by Statistics Korea, part of the Ministry of Strategy and Finance of South Korea [For covariates, the following information were collected: age, sex, body mass index (BMI), drinking status, smoking status, physical activity per week, laboratory variables (serum total cholesterol, high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol, aspartate aminotransferase [AST], alanine aminotransferase [ALT], gamma-glutamyl transferase [GGT]), systolic blood pressure, diastolic blood pressure, hypertension (ICD-10 codes: I10-13, I15), diabetes (ICD-10 codes: E11-14), and concomitant medications. For concomitant medication, information on other lipid lowering drugs (e.g., fibrate), calcium channel blocker, angiotensin-converting enzyme inhibitor, angiotensin II receptor blockers, beta-blocker, warfarin, aspirin, and anti-HBV medication were collected. Concomitant medications were defined if the patient had prescription identified based on Korean Drug and Anatomical Therapeutic Chemical Codes for the medication at 90 days prior to the index date.