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Beatrice A. Golomb, MD, PhD; Sabrina Koperski

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In the article by Shalev et al,¹ the authors improperly draw causal inferences from observational connections between statin therapy compliance and survival. Historically, associations of drug use and compliance with favorable health outcomes can depart from causal findings, not only in magnitude but also in direction (recall the hormone therapy "data" on cardiac events and dementia).

Lower cognitive function (whether or not promoted by worse health)^2-3 as well as lower conscientiousness^3-4 portend both lower statin therapy compliance³ and greater mortality.^{2, 4} In addition, unfavorable health factors predict risk of statin adverse effects,⁵ which are in turn linked to noncompliance,⁶ and do so disproportionately with high-potency statins.⁵ This forges a further link between lower compliance and higher mortality that is statin specific—and greater with high-dose statin use—but not attributable to statin therapy benefits.⁵ Creatine phosphokinase and liver function test results are inadequate to exclude statin . . . [Full Text of this Article]

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RELATED ARTICLE

Continuation of Statin Treatment and All-Cause Mortality: A Population-Based Cohort Study
Varda Shalev, Gabriel Chodick, Haim Silber, Ehud Kokia, Joseph Jan, and Anthony D. Heymann
Arch Intern Med. 2009;169(3):260-268.
ABSTRACT | FULL TEXT