Prior Statin Use Is Associated with Improved Outcomes in Community-acquired Pneumonia
Prior Statin Use Is Associated with Improved Outcomes in Community-acquired Pneumonia
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DOI：
10.1016/j.amjmed.2008.06.030
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发表时间：
2008-11-01
影响因子：
5.9
通讯作者：
Hill, Adam T.
中科院分区：
文献类型：
--
作者：
Chalmers, James D.;Singanayagam, Aran;Hill, Adam T.
背景：他汀类药物在肺部炎症的实验室研究中有很强的抗炎作用。方法：我们对2005年1月至2007年11月期间入院的社区获得性肺炎患者进行了前瞻性观察研究。记录他汀类药物、血管紧张素转换酶抑制剂、β-受体阻滞剂和阿司匹林的使用情况。结果：在多因素Logistic回归分析中，他汀类药物的使用与30天的死亡率显著降低(调整后的优势比[AOR]0.46，95%可信区间[CI]，0.25-0.85，P=0.05)。01)和并发肺炎(AOR 0.44，95%CI，0.25~0.79，P=。006)。对机械通气或正性肌力支持的需求无明显影响(AOR 0.93，95%CI，0.49~1.76，P=0.05)。8)。服用他汀类药物的患者肺炎更为严重(肺炎严重指数中位数为4，四分位数范围[IQR]3-4)，与未服用心血管药物的患者(肺炎严重程度中位数指数3，IQR 2-4，P
BACKGROUND: Statins have potent anti-inflammatory effects in laboratory studies of pulmonary inflammation. We investigated whether statin users had improved outcome when admitted with community-acquired pneumonia.METHODS: We carried out a prospective observational study of patients admitted to the hospital with community-acquired pneumonia between January 2005 and November 2007. The use of statins, angiotensin-converting enzyme inhibitors, beta-blockers, and aspirin were recorded. The outcomes of interest were 30-day mortality, need for mechanical ventilation or inotropic support, and the development of complicated pneumonia.RESULTS: On multivariate logistic regression, statin use was associated with significantly lower 30-day mortality (adjusted odds ratio [AOR] 0.46, 95% confidence interval [CI], 0.25-0.85, P = . 01) and development of complicated pneumonia (AOR 0.44, 95% CI, 0.25- 0.79, P =. 006). There was no effect on requirement of mechanical ventilation or inotropic support (AOR 0.93, 95% CI, 0.49-1.76, P =. 8). Patients prescribed statins had more severe pneumonia ( median Pneumonia Severity Index 4, interquartile range [IQR] 3- 4) compared with patients not prescribed cardiovascular drugs ( median Pneumonia Severity Index 3, IQR 2-4, P