title: The role of statin therapy in sepsis.
abstract: OBJECTIVE
  To systematically review the evidence evaluating the role of statin therapy in sepsis.
  
  
  METHODS
  MEDLINE, EMBASE, and PubMed were searched (1980-January 2007) for English-language clinical trials that evaluated the use of statins and the development and treatment of sepsis in human subjects. Search terms included statin, HMG-CoA reductase inhibitor, bacteremia, sepsis, septic shock, septicemia, and severe sepsis. In addition, pertinent references from identified articles were obtained.
  
  
  METHODS
  Only clinical trials with primary efficacy outcomes of mortality, incidence of sepsis, and severe sepsis were included.
  
  
  RESULTS
  Seven retrospective and 2 prospective cohort studies were included in this review. One was excluded because the patient population was not experiencing sepsis. Three studies demonstrated a reduced mortality with statin use while 2 other studies did not demonstrate this mortality benefit. One study suggested increased mortality with statin use in sepsis. Three studies showed a reduced incidence of development of sepsis or sepsis-related outcomes, while one study did not. The observational and retrospective nature of these studies and the higher rate of cardiovascular comorbidities in the statin groups may have allowed for a confounding influence. The conflicting results and heterogeneity between the studies makes the observed association between statin use and incidence of sepsis and sepsis-related mortality inconclusive. The clinical benefit of statin therapy in sepsis remains to be determined.
  
  
  CONCLUSIONS
  There is an association between statin use and a lower incidence of sepsis and sepsis-related mortality. However, a causal relationship between statin use and reduced sepsis-related mortality has not yet been established. Currently, statins cannot be recommended for sepsis prevention or treatment until controlled trials are performed.
authors: St. Paul's Hospital, Vancouver, BC, Canada. dchua@providencehealth.bc.ca
authors: Doson
authors: D
authors: Chua
authors: Ruth S
authors: RS
authors: Tsang
authors: I Fan
authors: IF
authors: Kuo
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D012042:Registries; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D012720:Severity of Illness Index
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors