Statin use is associated with reduced mortality in COPD
Statin use is associated with reduced mortality in COPD
复制标题
DOI：
10.1183/09031936.00106406
复制
发表时间：
2007-02-01
影响因子：
24.3
通讯作者：
Omland, T.
中科院分区：
文献类型：
--
作者：
Soyseth, V.;Brekke, P. H.;Omland, T.
慢性阻塞性肺疾病（COPD）患者患缺血性心脏病（IHD）的风险增加。他汀类药物可降低IHD患者的死亡率和发病率。据推测，他汀类药物治疗与COPD患者的长期死亡率降低有关。采用回顾性队列设计，854名连续患者（平均年龄70.8岁，51.5%为女性）从挪威一家教学医院出院时被诊断为COPD加重。中位随访时间为1.9年，期间有333名患者死亡。接受他汀类药物治疗的患者每1000人年的粗死亡率为110人，未接受他汀类药物治疗的患者为191人。在对性别、年龄、吸烟、肺功能和合并症进行校正后，他汀类药物服用者与非他汀类药物服用者的风险比（HR）为0.57（95%可信区间0.38-0.87）。当将他汀类药物服用者和非他汀类药物服用者根据吸入皮质类固醇（ICS）的联合治疗进行分组时，发现以下hr：仅吸入皮质类固醇的hr为0.75 (0.58-0.98)；仅他汀类药物为0.69 (0.36-1.3)；他汀类药物与ICS联合治疗与不联合治疗相比，其死亡率为0.39（0.22-0.67）。他汀类药物治疗与慢性阻塞性肺疾病加重后生存率的提高相关，而吸入皮质类固醇似乎增加了他汀类药物使用相关的生存率。
Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of ischaemic heart disease (IHD). Statins reduce mortality and morbidity in IHD. It has been hypothesised that statin treatment is associated with reduced long-term mortality in patients with COPD.Using a retrospective cohort design, 854 consecutive patients (mean age 70.8 yrs; 51.5% female) with a diagnosis of COPD exacerbation were included in the study at discharge from a Norwegian teaching hospital.Median follow-up was 1.9 yrs, during which 333 patients died. The crude mortality rate per 1,000 person-yrs was 110 in patients treated with statins, and 191 in patients not treated with statins. After adjustment for sex, age, smoking, pulmonary function and comorbidities, the hazard ratio (HR) for statin users versus statin nonusers was 0.57 (95% confidence interval 0.38-0.87). When subdividing statin users and statin nonusers into groups according to concomitant treatment with inhaled corticosterolds (ICS) the following HRs were found: 0.75 (0.58-0.98) for ICS only; 0.69 (0.36-1.3) for statins only; and 0.39 (0.22-0.67) for the combined treatment with statin and ICS compared with no such treatment.Treatment with statins was associated with improved survival after chronic obstructive pulmonary disease exacerbation, while inhaled corticosteroids appeared to increase the survival benefit associated with statin use.