Influenza and COPD mortality protection as pleiotropic, dose-dependent effects of statins

Influenza and COPD mortality protection as pleiotropic, dose-dependent effects of statins
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DOI：
10.1378/chest.06-1997
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发表时间：
2007-04-01
期刊：
CHEST
影响因子：
9.6
通讯作者：
Skipper, Betty
Skipper, Betty
中科院分区：
医学1区
文献类型：
--
作者：
Frost, Floyd J.;Petersen, Hans;Skipper, Betty

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背景资料：已发表的关于他汀类药物抗炎和免疫调节作用的数据表明，它们可能降低与对选定感染（包括流感和COPD）的未经检查的免疫应答相关的死亡风险。我们评估了他汀类药物使用者是否降低了这些conditions.Methods的死亡风险：我们进行了一项匹配的队列研究（n = 76，232）和两个独立的病例对照研究（397流感和207 COPD死亡），以评估他汀类药物治疗是否与增加或减少死亡风险和生存时间使用卫生保健遇到的健康维护组织的成员的数据。在队列研究中，使用他汀类药物治疗开始前所有原因的基线疾病风险，对治疗开始后结局的发生进行统计学调整。（>= 4 mg/d）他汀类药物使用者，该队列研究发现流感/肺炎死亡的比值比（OR）在统计学上显著降低（OR，0.60; 95%置信区间[CI]，0.44至0.81）和COPD死亡（OR，0.17; 95% CI，0.07至0.42），生存风险比也同样降低。病例对照研究证实了这一发现。未考虑的混杂因素可能解释了观察到的一些影响。结论：本研究发现，中度剂量他汀类药物使用者中COPD死亡的风险显著降低，流感死亡的风险显著降低。
Background: Published data on antinflammatory and immunomodulatory effects of statins suggest they may reduce mortality risks associated with an unchecked immune response to selected infections, including influenza and COPD. We assessed whether statin users had reduced mortality risks from these conditions.Methods: We conducted a matched cohort study (n = 76,232) and two separate case-control studies (397 influenza and 207 COPD deaths) to evaluate whether statin therapy is associated with increased or decreased mortality risk and survival time using health-care encounter data for members of health maintenance organizations. For the cohort study, baseline illness risks from all causes prior to initiation of statin therapy were used to statistically adjust for the occurrence of outcomes after initiation of treatment.Results: For moderate-dose (>= 4 mg/d) statin users, this cohort study found statistically significant reduced odds ratios (ORs) of influenza/pneumonia death (OR, 0.60; 95% confidence interval [CI], 0.44 to 0.81) and COPD death (OR, 0.17; 95% CI, 0.07 to 0.42) and similarly reduced survival hazard ratios. Findings were confirmed with the case-control studies. Confounding factors not considered may explain some of the effects observed.Conclusions: This study found a dramatically reduced risk of COPD death and a significantly reduced risks of influenza death among moderate-dose statin users.