The use of statins and lung function in current and former smokers.
BACKGROUND
Smokers are affected by a variety of inflammatory diseases, including COPD. Statins, 3-hydroxy-3-methyl-glutaryl-coenzyme-A reductase inhibitors, are used for their lipid-lowering characteristics but also appear to have antiinflammatory and immunomodulatory activities. We assessed their ability to preserve lung function in current and former smokers.


METHODS
All smokers and ex-smokers seen at the Oklahoma City VA hospital in 2005 with abnormal baseline spirometry findings and two or more pulmonary function tests done 6 months apart were classified into obstructive and restrictive groups based on the initial PFT result. Statin use, annual decline in FEV(1) and FVC, and need for respiratory-related urgent care (emergency department or inpatient) were compared.


RESULTS
Approximately one half, 215 of 418 patients, were receiving a statin. Compared to the control group, statin users had a lower decline in FEV(1) (- 0.005 +/- 0.20 L/yr vs 0.085 +/- 0.17 L/yr, p < 0.0001) and FVC (- 0.046 +/- 0.45 L/yr vs 0.135 +/- 0.32 L/yr, p < 0.0001) [mean +/- SD]. This difference remained significant irrespective of whether the patient had obstructive (n = 319), or restrictive (n = 99) disease, and regardless of whether the patient continued or stopped smoking. In patients with an obstructive spirometry finding, we found a lower incidence of respiratory-related urgent care in favor of the statin group (0.12 +/- 0.29 patient-years vs 0.19 +/- 0.32/patient-years; p = 0.02).


CONCLUSIONS
In smokers and former smokers, statins are associated with a slower decline in pulmonary function, independent of the underlying lung disease.


CONCLUSIONS
Prospective, randomized trials are needed to study the effect of statins on lung function.
Keddissi
Jean I
JI
Pulmonary and Critical Care Medicine, the Oklahoma City VA Medical Center, Oklahoma City, OK, USA. Jean-keddissi@ouhsc.edu
Younis
Walid G
WG
Chbeir
Elie A
EA
Daher
Nadim N
NN
Dernaika
Tarek A
TA
Kinasewitz
Gary T
GT
D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008173:Lung Diseases, Obstructive / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012907:Smoking / Q000503:physiopathology*; D014797:Vital Capacity / Q000187:drug effects* / Q000502:physiology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors