title: Effect of Prior Atorvastatin Treatment on the Frequency of Hospital Acquired Pneumonia and Evolution of Biomarkers in Patients with Acute Ischemic Stroke: A Multicenter Prospective Study.
abstract: Objective. To investigate whether prior treatment of atorvastatin reduces the frequency of hospital acquired pneumonia (HAP).Methods. Totally, 492 patients with acute ischemic stroke and Glasgow Coma Scale ≤ 8 were enrolled in this study. Subjects were assigned to prior atorvastatin treatment group (n= 268, PG) and no prior treatment group (n= 224, NG). All the patients were given 20 mg atorvastatin every night during their hospital stay. HAP frequency and 28-day mortality were measured. Levels of inflammatory biomarkers [white blood cell (WBC), procalcitonin (PCT), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6)] were tested.Results. There was no significant difference in the incidence of HAP between PG and NG (25.74% versus. 24.55%,p> 0.05) and 28-day mortality (50.72% versus 58.18%,p> 0.05). However, prior statin treatment did modify the mortality of ventilator associated pneumonia (VAP) (36.54% versus 58.14%,p= 0.041) and proved to be a protective factor (HR, 0.564; 95% CI, 0.310~0.825,p= 0.038). Concentrations of TNF-αand IL-6 in PG VAP cases were lower than those in NG VAP cases (p< 0.01).Conclusions. Prior atorvastatin treatment in patients with ischemic stroke was associated with a lower concentration of IL-6 and TNF-αand improved the outcome of VAP. This clinical study has been registered with ChiCTR-ROC-17010633 in Chinese Clinical Trial Registry.
authors.affiliation: Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
authors.forename: Yuetian
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Emergency, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
authors.forename: Cheng
authors.identifier: 0000-0002-0846-6740
authors.initials: C
authors.lastname: Zhu
authors.affiliation: Department of Emergency, Minhang District Central Hospital, Shanghai 201100, China.
authors.forename: Chunyan
authors.identifier: 0000-0003-4148-3822
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China.
authors.forename: Yuan
authors.identifier: 0000-0001-8271-2914
authors.initials: Y
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069059:Atorvastatin / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood; D003428:Cross Infection / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D020521:Stroke / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002116:Calcitonin; D000069059:Atorvastatin