Individuals who take cholesterol-lowering statins before being hospitalized with pneumonia appear less likely to die within 90 days afterward, according to a report in the October 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.1
Reimar W. Thomsen, M.D., Ph.D., of
“Mortality [death] among statin users was lower than among non-users: 10.3 percent vs. 15.7 percent after 30 days and 16.8 percent vs. 22.4 percent after 90 days,” the authors write. The lowest relative death rate associated with statins was observed in patients older than 80 and in those with bacteremia. “The differences became apparent during the first few weeks of hospitalization, a period associated with a high number of pneumonia-related deaths, and they increased only minimally between 30 and 90 days after admission, which suggests that statin use is beneficial primarily in the early phase of infection.”
Previous statin use, or the use of any other preventive medication for cardiovascular health, was not associated with a reduced death rate from pneumonia.
“Several biological mechanisms may explain our results,” the authors write. Statins change the immune response, beneficially affect processes associated with blood clotting and inflammation and inhibit dysfunction in blood vessels. These effects may especially benefit patients with sepsis and bacteremia, which are associated with early death from pneumonia.
“Our study adds to the accumulating evidence that statin use is associated with improved prognosis after severe infections,” the authors write. “The decrease in mortality associated with statin use seems to be substantial in patients with pneumonia requiring hospital admission. Randomized trials are needed to examine causality of the associations found in observational studies. Given the availability of statins, with their relatively low cost and mild adverse effects, positive results of statin therapy trials in patients with pneumonia would have substantial clinical and public health implications.”
“These data suggest a substantial decrease in mortality with statin use,” writes Kasturi Haldar, Ph.D., of the University of Notre Dame, South Bend.,
The resulting data “raises the question of whether statins should be used to improve anti-infective therapy. They are not optimal for treating acute infection because it takes days to achieve the desirable concentrations in plasma,” Dr. Haldar continues.
“However, because statins target the host, drug resistance, a major problem in treating bacterial infections, is not likely to develop. Thus, it may be useful to consider clinical research testing of combinations of statins with existing antibiotic agents to evaluate whether it is possible to develop optimized combination therapies effective against both acute and persistent infections.”
1. Arch Intern Med. 2008; 168:2081-2087.
2. Arch Intern Med. 2008;168:2067-2068.