Prior statin therapy is associated with a decreased rate of severe sepsis.
BACKGROUND
Statins have anti-inflammatory properties that are independent of their lipid-lowering abilities. We hypothesized that statin therapy before the onset of an acute bacterial infection may have a protective effect against severe sepsis. The aim of this study was to determine whether patients treated with statins develop severe sepsis less frequently.


RESULTS
In this prospective observational cohort study, consecutive patients admitted with presumed or documented acute bacterial infection were enrolled. The primary outcomes were the rate of severe sepsis and intensive care unit (ICU) admission. Of the 361 patients enrolled, 82 (22.7%) were treated with statins before their admission. Both groups had a similar severity of illness on admission. Severe sepsis developed in 19% of patients in the no-statin group and in only 2.4% of the statin group (P<0.001). Statin treatment was associated with a relative risk of developing severe sepsis of 0.13 (95% CI, 0.03 to 0.52) and an absolute risk reduction of 16.6%. The overall ICU admission rate was 10.2% (37/361): 12.2% of the no-statin group required ICU admission, whereas in the statin group only 3.7% were admitted to the ICU (P=0.025), reflecting a relative risk of ICU admission of 0.30 (95% CI, 0.1 to 0.95).


CONCLUSIONS
Prior therapy with statins may be associated with a reduced rate of severe sepsis and ICU admission. If supported by prospective controlled trials, statins may have a role in the primary prevention of sepsis.
Medical Intensive Care Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel. almogya@bgumail.bgu.ac.il
Yaniv
Y
Almog
Alexander
A
Shefer
Victor
V
Novack
Nimrod
N
Maimon
Leonid
L
Barski
Miruna
M
Eizinger
Michael
M
Friger
Lior
L
Zeller
Abraham
A
Danon
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002481:Cellulitis / Q000150:complications; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004731:Endotoxins / Q000097:blood; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000453:epidemiology; D007155:Immunologic Factors / Q000627:therapeutic use*; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007557:Israel / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D018410:Pneumonia, Bacterial / Q000150:complications; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012306:Risk; D018805:Sepsis / Q000453:epidemiology / Q000517:prevention & control*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D014552:Urinary Tract Infections / Q000150:complications
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004731:Endotoxins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007155:Immunologic Factors; D008055:Lipids