The effects of statin therapy on mortality in patients with sepsis

Chen, Mengyan; Ji, Mingxia; Si, Xiaoshui

doi:10.1097/md.0000000000011578

Cited by 27 publications

(25 citation statements)

References 30 publications

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“…[55][56][57][58][59][60][61] Nevertheless, a recent meta-analysis of seven randomised clinical trials showed no benefit of statin therapy on mortality in patients with sepsis compared with placebo. 62 Our findings, on the other hand, demonstrated a clear mortality benefit with statin therapy independent of other covariates and warrant further studies to validate these results.…”

Section: Open Accesssupporting

confidence: 62%

Hyperlipidaemia and mortality among patients hospitalised with pneumonia: retrospective cohort and propensity score matched study

et al. 2021

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ObjectiveTo characterise the potential association of hyperlipidaemia (HLP) versus no HLP with all-cause mortality among patients hospitalised for pneumonia.DesignPropensity score matched retrospective study.ParticipantsThe study cohort consisted of consecutive 8553 adults hospitalised at a large academic centre with a discharge diagnosis of pneumonia from 1996 through 2015, followed until death or end of the study period, 17 August 2017.OutcomesThe outcome was HR for mortality at 28 days and in the long term in patients with pneumonia with concurrent HLP compared with those with no HLP. We first constructed multivariable Cox proportional regression models to estimate the association between concurrent HLP versus no HLP and mortality after pneumonia hospitalisation for the entire cohort. We then identified 1879 patients with pneumonia with concurrent HLP and propensity score matched in a 1:1 ratio to 1879 patients with no HLP to minimise the imbalance from measured covariates for further analysis.ResultsAmong 8553 unmatched patients with pneumonia, concurrent HLP versus no HLP was independently associated with lower mortality at 28 days (HR 0.52, 95% CI 0.41 to 0.66) and at a median follow-up of 3.9 years (HR 0.75, 95% CI 0.70 to 0.80). The risk difference in mortality was consistent between 1879 propensity score matched pairs both at 28 days (HR 0.65, 95% CI 0.49 to 0.86) and at a median follow-up of 4 years (HR 0.88, 95% CI 0.81 to 0.96). In the subgroup of patients with clinically measured low-density lipoprotein cholesterol (LDL-C), graded inverse associations between LDL-C levels and mortality were found in both unmatched and matched cohorts.ConclusionsAmong hospitalised patients with pneumonia, a diagnosis of HLP is protective against both short-term and long-term risk of death after adjustment for other major contributors to mortality in both unmatched and propensity score matched cohorts. These findings should be further investigated.

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Section: Open Accesssupporting

confidence: 62%

Hyperlipidaemia and mortality among patients hospitalised with pneumonia: retrospective cohort and propensity score matched study

et al. 2021

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“…Moreover, a randomized trial of the effect of atorvastatin in patients with severe sepsis indicated that prior statin users had lower 28-day mortality than placebo users [33]. However, a meta-analysis of nine randomized trial studies concluded that statin therapy had no effect on mortality outcomes in patients with sepsis compared with placebo users [34]. In a previous double-blind investigation, treatment of hypercholesterolemia with lovastatin did not cause psychological distress or substantially alter cognitive function [35].…”

Section: Discussionmentioning

confidence: 99%

Association between Statin Use and Sepsis Risk in Patients with Dementia: A Retrospective Cohort Study

Yeh

Tang

Yang

et al. 2019

IJERPH

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This study investigated the association of statin use with sepsis risk in patients with dementia. This retrospective cohort study was conducted in Taiwan by using data from the National Health Insurance Research Database. We identified and enrolled 308 patients with newly diagnosed dementia who used statin after dementia diagnosis. These patients were individually propensity score matched (1:1) according to age, sex, hypertension, hyperlipidemia, diabetes, cerebrovascular disease, renal disease, liver disease, asthma, malignancy, parkinsonism, and dementia drugs used (donepezil, rivastigmine, galantamine, and memantine) with 251 controls (statin non-users). A Cox proportional hazard model was used to estimate the adjusted hazard ratio for sepsis in statin users and non-users. After adjustment for other confounding factors, the incidence of sepsis in statin users was 1.42-fold higher than that in non-users (95% confidence interval = 0.81–2.5). In conclusion, our analysis showed no positive association of sepsis with statin use in patients with dementia.

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“…Simvastatin had been proved to be effective in hemodynamic stabilization, improved responses to beta-adrenergic vasopressin drugs, increasing blood pressure, and decreased adhesion of polynuclear cells to the previously activated endothelium in animal study. [10,11,16] Although a meta-analysis based on 9 prospective randomized trials had concluded that statin could not improve mortality in septic patients compared with placebo-controls, [17] a meta-analysis of 27 observational studies concluded that statin treatment could reduce mortality by 35% in patients of sepsis. [14] In this current cohort study, we concluded that the use of statins after post-sepsis discharge improved the long-term prognosis of patients who had survived sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…It is described as a higher health awareness and healthier lifestyle in patients of statin-users, compared with nonstatin users. [14,17,29] According to this theory, statin-users are more likely to seek out preventive healthcare services, such as screening tests and vaccinations. [29,30] However, it is quite difficult to measure the factors involving lifestyle, prevention behavior toward disease, and compliance of drugs in observational studies.…”

Section: Discussionmentioning

confidence: 99%