title: Statins, systemic inflammation and risk of death in COPD: the Rotterdam study.
abstract: BACKGROUND
  Studies suggest that statins decrease mortality in COPD patients but it is unknown which patients might benefit most.
  
  
  OBJECTIVE
  We investigated whether statins were associated with reduced mortality in COPD patients and whether effects differed according to baseline high-sensitivity C-reactive protein (hsCRP) concentration, a marker of systemic inflammation.
  
  
  METHODS
  This nested case-control study was part of the Rotterdam Study, a prospective population-based cohort study among 7983 subjects ≥ 55 years. Using automated pharmacy records, we evaluated statin use of 363 cases (COPD patients who died during follow-up of 17 years) with 2345 age and sex matched controls (COPD patients who survived the follow-up period of the index case).
  
  
  RESULTS
  Compared to never use, long-term statin use (>2 years) was associated with a 39% decreased risk of death in COPD patients. Stratified according to the level of systemic inflammation, long-term statin use was associated with a 78% reduced mortality if hsCRP level > 3 mg/L, versus a non significant 21% reduced mortality if hsCRP level ≤ 3 mg/L.
  
  
  CONCLUSIONS
  Statin use is associated with a beneficial effect on all-cause mortality in COPD, depending on the baseline level of systemic inflammation.
authors.affiliation: Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. lies.lahousse@ugent.be
authors.forename: Lies
authors.initials: L
authors.lastname: Lahousse
authors.forename: Daan W
authors.initials: DW
authors.lastname: Loth
authors.forename: Guy F
authors.initials: GF
authors.lastname: Joos
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Hubert G M
authors.initials: HG
authors.lastname: Leufkens
authors.forename: Guy G
authors.initials: GG
authors.lastname: Brusselle
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007249:Inflammation / Q000401:mortality*; D008297:Male; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000401:mortality*; D012306:Risk
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein