title: Statin use and risk of COPD exacerbation requiring hospitalization.
abstract: BACKGROUND
  Despite recent studies that suggested statins' beneficial effects on chronic obstructive pulmonary disease (COPD) outcomes, the impact, if any, of statins on COPD exacerbations remains unclear. This study aimed to examine the association between statin use and risk of hospitalized COPD exacerbation, and to assess whether the association varied by statin initiation, dose, or duration of use.
  
  
  METHODS
  A retrospective nested case-control study among patients with COPD was conducted analyzing a nationwide health insurance claims database in Taiwan. Cases were subjects hospitalized for COPD exacerbations; each case was matched to 4 randomly selected controls on age, sex, cohort entry, and number of COPD-related outpatient visits by an incident-density sampling approach. Conditional logistic regressions were employed to quantify the COPD exacerbation risk associated with statin use.
  
  
  RESULTS
  The study cohort comprised 14,316 COPD patients, from which 1584 cases with COPD exacerbations and 5950 matched controls were identified. Any use of statins was associated with a 30% decreased risk of COPD exacerbation (95% confidence interval [CI], 0.56-0.88), and current use of statins was related to a greater reduced risk (adjusted odds ratio [OR] 0.60; 95% CI, 0.44-0.81). A dose-dependent reduced risk of COPD exacerbation by statins was observed (medium average daily dose: adjusted OR 0.60; 95% CI, 0.41-0.89; high daily dose: adjusted OR 0.33; 95% CI, 0.14-0.73). The reduced risk remained significant for either short or long duration of statin use.
  
  
  CONCLUSIONS
  Statin use was associated with a reduced risk of COPD exacerbation, with a further risk reduction for statins prescribed more recently or at high doses.
authors.affiliation: School of Pharmacy, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. wmt@mail.ndmctsgh.edu.tw
authors.forename: Meng-Ting
authors.initials: MT
authors.lastname: Wang
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Lo
authors.forename: Cheng-Liang
authors.initials: CL
authors.lastname: Tsai
authors.forename: Li-Chien
authors.initials: LC
authors.lastname: Chang
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Malone
authors.forename: Che-Li
authors.initials: CL
authors.lastname: Chu
authors.forename: Jun-Ting
authors.initials: JT
authors.lastname: Liou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D018450:Disease Progression; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008875:Middle Aged; D017891:Pharmacoepidemiology / Q000379:methods; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D013624:Taiwan / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors