title: Effect of the use of low and high potency statins and sepsis outcomes.
abstract: BACKGROUND
  Although statins have been shown to have cholesterol-lowering effects, their pleiotropic benefits on sepsis remain a matter of debate. In addition, the influence of statin potency on sepsis-related mortality has never been explored. The aim of our study was to determine the sepsis outcomes of low- and high-potency statin users and non-users.
  
  
  METHODS
  This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan's National Health Insurance program. Patients were hospitalized for sepsis between 2000 and 2010. All-cause mortality and major adverse consequences of sepsis, such as in-hospital death, intensive care unit admission, shock events, and the use of mechanical ventilation, were assessed. Patients were divided into high-potency statin users (at least 10 mg rosuvastatin, at least 20 mg atorvastatin, or at least 40 mg simvastatin), low-potency statin users (all other statin treatments), and non-users.
  
  
  RESULTS
  A propensity score-matched cohort of 27,792 statin users and 27,792 non-users was included. Of 27,792 statin users, 9,785 (35.2 %) were treated with high-potency statins and 18,007 (64.8 %) were treated with low-potency statins. The 1-year mortality risk was significantly lower among both low-potency [adjusted hazard ratio (aHR) 0.89, 95 % confidence interval (CI) 0.85-0.93] and high-potency (aHR 0.80, 95 % CI 0.75-0.86) statin users compared with non-users. The risks of mortality and adverse consequences of sepsis were lower among high-potency than among low-potency statin users.
  
  
  CONCLUSIONS
  High-potency statin use is associated with a lower risk of sepsis-related mortality compared with low-potency statin use.
authors.affiliation: School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Ou
authors.forename: Hsi
authors.initials: H
authors.lastname: Chu
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Chao
authors.forename: Shuo-Ming
authors.initials: SM
authors.lastname: Ou
authors.forename: Yi-Jung
authors.initials: YJ
authors.lastname: Lee
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Kuo
authors.forename: Szu-Yuan
authors.initials: SY
authors.lastname: Li
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Shih
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Chen
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D057216:Propensity Score; D016016:Proportional Hazards Models; D018570:Risk Assessment; D018805:Sepsis / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D013624:Taiwan / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
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