title: Statin therapy is associated with decreased pulmonary vascular pressures in severe COPD.
abstract: BACKGROUND
  Pulmonary hypertension (PH) in COPD carries a poor prognosis. Statin therapy has been associated with numerous beneficial clinical effects in COPD, including a possible improvement in PH. We examined the association between statin use and pulmonary hemodynamics in a well-characterized cohort of patients undergoing evaluation for lung transplantation.
  
  
  METHODS
  We conducted a cross-sectional analysis of 112 subjects evaluated for lung transplant with a diagnosis of COPD. Clinical characteristics, pulmonary function, cardiac catheterization findings and medical comorbidities were compared between statins users and non-users.
  
  
  RESULTS
  Thirty-four (30%) subjects were receiving statin therapy. Statin users were older and had an increased prevalence of systemic hypertension and coronary artery disease (CAD). Mean pulmonary arterial pressure (mPAP) in the statin group was lower [26 ± 7 vs 29 ± 7 mmHg, p = 0.02], as was pulmonary artery wedge pressure (PAWP) [12 ± 5 vs. 15 ± 6 mmHg, p = 0.02]. Pulmonary vascular resistance did not differ between the groups. In multiple regression analysis, statin use was associated with a 4.2 mmHg (95% CI: 2 to 6.4, p = <0.001) lower PAWP and a 2.6 mmHg (95% CI: 0.3 to 4.9, p = 0.03) reduction in mPAP independent of PAWP.
  
  
  CONCLUSIONS
  In patients with severe COPD, statin use is associated with significantly lower PAWP and mPAP. These finding should be evaluated prospectively.
authors.affiliation: University of Maryland School of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland 21201, USA. rreed@medicine.umaryland.edu
authors.forename: Robert M
authors.initials: RM
authors.lastname: Reed
authors.forename: Aldo
authors.initials: A
authors.lastname: Iacono
authors.forename: Andrew
authors.initials: A
authors.lastname: DeFilippis
authors.forename: Steven
authors.initials: S
authors.lastname: Jones
authors.forename: Michael
authors.initials: M
authors.lastname: Eberlein
authors.forename: Noah
authors.initials: N
authors.lastname: Lechtzin
authors.forename: Reda E
authors.initials: RE
authors.lastname: Girgis
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D003430:Cross-Sectional Studies; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy*; D011669:Pulmonary Wedge Pressure / Q000187:drug effects*; D011758:Pyrroles / Q000494:pharmacology / Q000627:therapeutic use*; D012044:Regression Analysis; D019821:Simvastatin / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin