Prior Statin Therapy Is Associated With a Decreased Rate of Severe Sepsis

Abstract

Background-Statins have anti-inflammatory properties that are independent of their lipid-lowering abilities. We hypothesized that statin therapy before the onset of an acute bacterial infection may have a protective effect against severe sepsis.

Lovastatin Enhances Clearance of Apoptotic Cells (Efferocytosis) with Implications for Chronic Obstructive Pulmonary Disease

“…In a Klebsiella pneumoniae mouse model of pneumonia, lovastatin delayed bacterial clearance and enhanced dissemination (2). In contrast, statins have consistently improved survival in animal and human bacterial sepsis (16,22,83), implying that the beneficial effects of statins may outweigh their potential deleterious effects.…”

Statins as antiinflammatory and immunomodulatory agents: A future in rheumatologic therapy?

“…Multivariate analysis further revealed that only statin use was associated with a decreased mortality rate (132). In a prospective observational cohort study of 361 patients with bacterial infection, statin use was independently associated with a significantly lower rate of severe sepsis (P ϭ 0.001), in addition to a lower relative risk of death (0.43) (133). The results of the latter 2 studies are not yet conclusive; a randomized controlled trial of statin use in sepsis may be warranted.…”

Can statins improve outcome in colorectal surgery?: Part I

“…On the other hand, there are evidences [21][22][23][24] and controversies [25][26][27][28][29] that require a better definition that statins, independent of their primary action, help reduce mortality in the treatment of sepsis 21,25,30 , supposedly for inhibiting the synthesis of products of the cholesterol metabolic pathway just before mevalonate is produced, preventing the production of substances such as isoprenoids and geranylgeranyl pyrophosphate 31 . In addition, they modify the intercellular interaction and the chemotaxis of the immune system; have antioxidant properties, although reducing the levels of ubiquinone (CoQ10), an endogenous oxidant 32 ; act against apoptosis; inhibit the action of certain genes, changing the cellular activity; and participate, in other mechanisms, of the inflammatory response 30 , facts that intensify their capability to control the systemic inflammatory response syndrome and protect cardiac patients from complications of noncardiac surgeries [33][34][35] or in similar situations triggered by the infection [22][23][24]36,37 .…”

“…However, most studies testing the effect of statins in the treatment of severe diseases present methodological limitation and are retrospective studies 30 . Almog et al 21 , in a prospective study with the participation of several researchers, consecutively enrolled 361 patients admitted with presumed or documented acute bacterial infection. These patients presented high rates of severe sepsis and transference to the intensive care unit.…”