• Chien-Chang Lee, Lee Meng-Tse Gabriel MG Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan., Tzu-Chun Hsu, Lorenzo Porta, Shy-Shin Chang, Chia-Hung Yo, Kuang-Chau Tsai, and Matthew Lee.
• Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: cclee100@gmail.com.
• Chest. 2018 Apr 1; 153 (4): 805-815.

BackgroundWhether statin treatment, proved by recent experimental studies to have an antimicrobial activity, exerts a drug- or a class-specific effect in sepsis remains unknown.MethodsShort-term mortality in patients with sepsis was analyzed using data from the National Health Insurance Research Database. Use of statins was defined as the cumulative use of a specific statin (atorvastatin, simvastatin, or rosuvastatin) for > 30 days prior to the index sepsis admission. We determined the association between statin and sepsis outcome by multivariate-adjusted Cox models and propensity score (PS)-matched analysis, using a 1:1:1 PS matching technique.ResultsA total of 52,737 patients with sepsis fulfilled the inclusion criteria, of which 1,855 were prescribed atorvastatin, 916 were prescribed simvastatin, and 732 were prescribed rosuvastatin. Compared with nonusers, simvastatin (hazard ratio [HR], 0.72; 95% CI, 0.58-0.90) and atorvastatin (HR, 0.78; 95% CI, 0.68-0.90) were associated with an improved 30-day survival, whereas rosuvastatin was not (HR, 0.87; 95% CI, 0.73-1.04). Using rosuvastatin as the reference, atorvastatin (HR, 0.79; 95% CI, 0.64-0.99) and simvastatin (HR, 0.77; 95% CI, 0.59-0.99) had superior effectiveness in preventing mortality.ConclusionsCompatible with in vitro experimental findings, our results suggest that the drug-specific effect of statins on sepsis is not correlated to their lipid-lowering potency.Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

27 keywords...

hide…