Statin use does not affect the outcome of acute infection: a prospective cohort study.
Statins are used to prevent atherosclerosis because of their hypolipemic effects. In vitro testing and murine models suggest that statins may affect outcome in sepsis. Our meta-analysis of epidemiological studies in humans confirms that previous statin use appears to have a protective effect on infection rates and outcomes. The studies considered, however, were very different and heterogeneity was high, especially for mortality criteria.


OBJECTIVE
To compare outcome for current statin users and nonusers hospitalized with fever, under pragmatic circumstances.


METHODS
Prospective cohort study.


METHODS
University Hospital of Brest (France).


METHODS
Febrile (>38 degrees C) patients older than 40 years, admitted to the hospital on an emergency basis in 2005. Patients' outcome was compared according to their exposure to statins (current user or nonuser).


METHODS
Mortality, length of hospitalization, admission to ICU and to convalescent homes


RESULTS
Of 40 343 patients referred for admission by the emergency department in 2005, 964 patients older than 40 years had a fever higher than 38 degrees C and were included in the study. Statin-user status, however, was available for only 921. The ICU admission rate (relative risk: 4.69; 95% CI: 2.42-9.08) was significantly higher (p=0.009) among statin users (n=139) than nonusers (n=782). The groups had similar lengths of hospitalization and similar rates of mortality and of convalescent home admissions.


CONCLUSIONS
Our study does not confirm that statin use affects infection outcome and suggests that previous findings may be associated instead with more cautious care or nonspecific cardiovascular prevention rather than with a specific infection-related effect. Thus, these data support the continuation of statin therapy during physiological aggression, including infection.
de Saint Martin
Luc
L
CHU Brest, Service Médecine Interne, Brest, F- 29200 France. luc.desaintmartin@chu-brest.fr
Tandé
Didier
D
Goetghebeur
David
D
Pan-Lamandé
Marie
M
Segalen
Yann
Y
Pasquier
Elisabeth
E
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007239:Infections / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors