title: The effect of statin therapy on infection-related mortality in patients with atherosclerotic diseases.
abstract: OBJECTIVE
  Statins have pleiotropic effects that are independent of their lipid-lowering ability. We have previously shown that prior statin therapy is associated with a decreased risk of severe sepsis in patients admitted with acute bacterial infection. The aim of this study was to determine whether statin therapy is associated with a decreased risk of infection-related mortality.
  
  
  METHODS
  A prospective, observational, population-based study.
  
  
  METHODS
  Tertiary university medical center.
  
  
  METHODS
  Using a computerized database, 11,490 patients with atherosclerotic diseases were identified and followed for up to 3 yrs. Two groups of patients were compared: those receiving statins in the final month before follow-up termination and those who were not.
  
  
  METHODS
  None.
  
  
  RESULTS
  The primary outcome was infection-related mortality. Of the 11,362 patients included in the final analysis, 5,698 (50.1%) belonged to the statin group. Median follow-up was 19.8 months (interquartile range, 14.3-33.3). The risk of infection-related mortality was significantly lower in the statin compared with the no-statin group (0.9% vs. 4.1%), reflecting a relative risk of 0.22 (95% confidence interval, 0.17-0.28). Stepwise Cox proportional hazard survival analysis including a propensity score for receiving statins revealed that the protective effect of statins adjusted for all known potential confounders remained highly significant (hazard ratio, 0.37; 95% confidence interval, 0.27-0.52).
  
  
  CONCLUSIONS
  Therapy with statins may be associated with a reduced risk of infection-related mortality. This protective effect is independent of all known comorbidities and dissipates when the medication is discontinued. If this finding is supported by prospective controlled trials, statins may play an important role in the primary prevention of infection-related mortality.
authors.affiliation: Medical Intensive Care Unit, Soroka University Medical Center, Beer-Sheva, Israel.
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Almog
authors.forename: Victor
authors.initials: V
authors.lastname: Novack
authors.forename: Miruna
authors.initials: M
authors.lastname: Eisinger
authors.forename: Avi
authors.initials: A
authors.lastname: Porath
authors.forename: Lena
authors.initials: L
authors.lastname: Novack
authors.forename: Harel
authors.initials: H
authors.lastname: Gilutz
mesh_terms: D050197:Atherosclerosis / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000401:mortality* / Q000517:prevention & control*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors