Pre-admission statin use and in-hospital severity of 2009 pandemic influenza A(H1N1) disease.
Pre-admission statin use and in-hospital severity of 2009 pandemic influenza A(H1N1) disease.
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DOI：
10.1371/journal.pone.0018120
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发表时间：
2011-04-25
期刊：
影响因子：
3.7
通讯作者：
Influenza Clinical Information Network (FLU-CIN)
中科院分区：
文献类型：
--
作者：
Brett SJ;Myles P;Lim WS;Enstone JE;Bannister B;Semple MG;Read RC;Taylor BL;McMenamin J;Nicholson KG;Nguyen-Van-Tam JS;Openshaw PJ;Influenza Clinical Information Network (FLU-CIN)
他汀类药物是用于降低血浆胆固醇水平的药物。最近，关于他汀类药物对各种炎症性疾病（包括感染）进展的可能额外影响，出现了相互矛盾的说法。因此，我们研究了2009年甲型H1N1流感住院患者的临床过程，这些患者在入院时服用或未服用他汀类药物。使用英国流感临床信息网络（FLU-CIN）数据库进行了一项回顾性病例对照研究，该数据库包含2009年4月至2010年1月期间确诊感染2009年甲型H1N1流感的1，520名参与医院患者的详细信息。我们的分析仅限于34岁以上的人。单变量分析用于计算影响进展为严重结局（高度依赖或重症监护病房水平支持）或死亡（病例）的因素的未校正比值比（OR）和95%置信区间（95%CI）;然后建立年龄和性别以及年龄、性别、肥胖和“他汀类药物适应症”（例如，心脏病或高胆固醇血症）。我们发现入院前使用他汀类药物与经年龄和性别校正后的结局严重程度之间无统计学显著相关性[校正OR：0.81（95%CI：0.46-1.38）; n = 571]。 校正年龄、性别、肥胖和他汀类药物适应症后，入院前使用他汀类药物与重度结局之间的相关性无统计学意义;点估计值与他汀类药物使用的小但具有临床意义的保护作用一致[校正OR：0.72（95% CI：0.38-1.33）]。在这组因大流行性流感住院的患者中，未发现入院前使用他汀类药物对住院期间病程的显著有益影响。虽然这些观察结果的数据库代表了最大的可用的合适的英国医院队列，但需要更大规模的研究来确认这种情况下是否有任何益处。
Statins are drugs that are used to lower plasma cholesterol levels. Recently, contradictory claims have been made about possible additional effects of statins on progression of a variety of inflammatory disorders, including infections. We therefore examined the clinical course of patients admitted to hospital with 2009 pandemic influenza A(H1N1), who were or weren't taking statins at time of admission. A retrospective case-control study was performed using the United Kingdom Influenza Clinical Information Network (FLU-CIN) database, containing detailed information on 1,520 patients admitted to participating hospitals with confirmed 2009 pandemic influenza A(H1N1) infection between April 2009 and January 2010. We confined our analysis to those aged over 34 years. Univariate analysis was used to calculate unadjusted odds ratios (OR) and 95 percent confidence intervals (95%CI) for factors affecting progression to severe outcome (high dependency or intensive care unit level support) or death (cases); two multivariable logistic regression models were then established for age and sex, and for age, sex, obesity and “indication for statin” (e.g., heart disease or hypercholesterolaemia). We found no statistically significant association between pre-admission statin use and severity of outcome after adjustment for age and sex [adjusted OR: 0.81 (95% CI: 0.46–1.38); n = 571]. After adjustment for age, sex, obesity and indication for statin, the association between pre-admission statin use and severe outcome was not statistically significant; point estimates are compatible with a small but clinically significant protective effect of statin use [adjusted OR: 0.72 (95% CI: 0.38–1.33)]. In this group of patients hospitalized with pandemic influenza, a significant beneficial effect of pre-admission statin use on the in-hospital course of illness was not identified. Although the database from which these observations are derived represents the largest available suitable UK hospital cohort, a larger study would be needed to confirm whether there is any benefit in this setting.
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影响因子：
10
作者：
Bewick T;Myles P;Greenwood S;Nguyen-Van-Tam JS;Brett SJ;Semple MG;Openshaw PJ;Bannister B;Read RC;Taylor BL;McMenamin J;Enstone JE;Nicholson KG;Lim WS;Influenza Clinical Information Network
通讯作者：
Influenza Clinical Information Network
DOI：
10.1086/591708
发表时间：
2008-10-01
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Morens DM;Taubenberger JK;Fauci AS
通讯作者：
Fauci AS
影响因子：
4.2
作者：
Fleming, D. M.;Verlander, N. Q.;Nguyen-Van-Tam, J. S.
通讯作者：
Nguyen-Van-Tam, J. S.
DOI：
10.1136/bmj.b2137
发表时间：
2009-06-16
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Dublin S;Jackson ML;Nelson JC;Weiss NS;Larson EB;Jackson LA
通讯作者：
Jackson LA
影响因子：
105.7
作者：
Majumdar, Sumit R.;McAlister, Finlay A.;Marrie, Thomas J.
通讯作者：
Marrie, Thomas J.