title: Impact of statins and angiotensin-converting enzyme inhibitors on mortality of subjects hospitalised with pneumonia.
abstract: Recent studies suggest that statins and angiotensin-converting enzyme (ACE) inhibitors may have beneficial effects for some types of infections. The present study aimed to examine the association of outpatient use of these medications on 30-day mortality for subjects aged >65 yrs and hospitalised with community-acquired pneumonia. A retrospective national cohort study was conducted using the Department of Veterans Affairs administrative data including subjects aged >/=65 yrs hospitalised with community-acquired pneumonia, and having >/=1 yr of prior Veterans Affairs outpatient care. In total, 8,652 subjects were identified with a mean age of 75 yrs, 98.6% were male, and 9.9% of subjects died within 30 days of presentation. In this cohort, 18.1% of subjects were using statins and 33.9% were using ACE inhibitors. After adjusting for potential confounders, current statin use (odds ratio (OR) 0.54, 95% confidence interval (CI) 0.42-0.70) and ACE inhibitor use (OR 0.80, 95% CI 0.68-0.89) were significantly associated with decreased 30-day mortality. Use of statins and angiotensin-converting enzyme inhibitors prior to admission is associated with decreased mortality in subjects hospitalised with community-acquired pneumonia. Randomised controlled trials are needed to examine whether the use of these medications in patients hospitalised with community-acquired pneumonia may be beneficial.
authors.affiliation: VERDICT, ALMD/UTHSCSA, Ambulatory Care (11C6), 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA. mortensene@uthscsa.edu
authors.forename: E M
authors.initials: EM
authors.lastname: Mortensen
authors.forename: M J
authors.initials: MJ
authors.lastname: Pugh
authors.forename: L A
authors.initials: LA
authors.lastname: Copeland
authors.forename: M I
authors.initials: MI
authors.lastname: Restrepo
authors.forename: J E
authors.initials: JE
authors.lastname: Cornell
authors.forename: A
authors.initials: A
authors.lastname: Anzueto
authors.forename: J A
authors.initials: JA
authors.lastname: Pugh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D016017:Odds Ratio; D011014:Pneumonia / Q000150:complications / Q000401:mortality*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors