Statins may be beneficial for patients with pulmonary hypertension secondary to lung diseases

Abstract

Background: Previous animal studies and clinical trials report inconsistent findings regarding the role of statins in pulmonary hypertension (PH). Systematic reviews have shown no use of statins on pulmonary arterial hypertension (PAH). This is the first meta-analysis of randomized controlled trials (RCTs) determining the clinical impacts of statin therapy on patients with PH secondary to lung diseases.Methods: Electronic databases and manual bibliographical searches were conducted. Eligible studies included RCTs of at least 3 months that evaluated statin therapy as compared with control in adult patients with PH due to pulmonary diseases. Statistical analyses were performed to calculate mean difference, relative risks (RRs), and 95% confidence intervals (CIs) using random-effect model.Results: A total of 6 RCTs were identified and included in this study. Five trials reported the effects of statins in patients with both chronic obstructive pulmonary disease (COPD) and PH, and the remaining 1 was based on PH due to pneumoconiosis. We found that statin therapy was associated with increased 6-minute walk distance and reduced pulmonary artery systolic pressure. There was no observed difference in the incidence of death, drug withdrawal, and adverse event between statin and control group.Conclusions: Our findings suggest that statins might be safe and beneficial for patients with PH due to chronic lung diseases. However, larger RCTs with more patients and longer observational duration are needed.

Effectiveness of long-term using statins in COPD – a network meta-analysis

“…However, it didn’t study COPD death. Zhang et al found [17] that statins therapy was associated with reduced pH which including six studies, the SMD (95% CI) was − 0.70 (− 0.99, − 0.41). PH is a serious and progressive vascular disease, which is yet incurable and generally results in heart failure and death.…”

“…What needs to be emphasized is that anti-inflammatory actions modulate the immune system and reduce inflammatory markers such as CRP and IL-6 are slowly being discovered [11, 14]. Systematic reviews prior to 2017 have been suggested that statins are associated with a beneficial role in treatment of COPD [15–17], which including reduce all-cause mortality, cause-specific mortality and PH. Li et al research which including twenty studies with a total of 303,981 patients found [16] statins reduced all-cause mortality and COPD exacerbation, but not to hospitalization.…”

“…Li et al research which including twenty studies with a total of 303,981 patients found [16] statins reduced all-cause mortality and COPD exacerbation, but not to hospitalization. Zhang et al which including 6 RCTS with both COPD and PH patients found statin therapy was associated with increased 6-min walk test (6 MW) and reduced PH, but there was no observed difference in all-cause mortality [17]. Whether statins can reduce inflammation and PH or not remains controversial [17, 18].…”

“…Zhang et al which including 6 RCTS with both COPD and PH patients found statin therapy was associated with increased 6-min walk test (6 MW) and reduced PH, but there was no observed difference in all-cause mortality [17]. Whether statins can reduce inflammation and PH or not remains controversial [17, 18].…”

New applications of statin in therapy

“…potwierdzono, że statyny zmniejszają częstość zaostrzeń, częstość hospitalizacji i antybiotykoterapii u pacjentów z POCH, ponadto przyjmowanie statyn wiązało się ze znacznie mniejszą liczbą hospitalizacji w oddziale ratunkowym [29]. W innym badaniu wskazuje się na korzystne działanie statyn u pacjentów z nadciśnieniem płucnym powstałym w przebiegu przewlekłych chorób płuc, w tym POCH, a terapia statynami wiązała się ze zwiększeniem wydajności wysiłkowej i zmniejszeniem ciśnienia w tętnicy płucnej [31]. Opublikowane wyniki badań retrospektywnych stoją w sprzeczności z opublikowanym w 2014 r.…”