NEW YORK (Reuters Health) – Patients who use statins prior to hospitalization for pneumonia are less likely to die after discharge than their peers who were not using these agents, according to a report in the October 27th issue of the Archives of Internal Medicine.

Previous reports have suggested that statin therapy may improve outcomes in patients with sepsis or bacteremia. However, studies examining the impact on pneumonia outcomes have yielded conflicting results, Dr. Reimar W. Thomsen, from Aarhus University in Aalborg, Denmark, and colleagues note.

To investigate this further, the researchers conducted a population-based cohort study involving nearly 30,000 adults who were hospitalized with pneumonia in northern Denmark from January 1997 to December 2004. Data on medication use, comorbid conditions, infectious complications, and mortality were included in the analysis.

Overall, 4.6% of patients were statin users at the time of hospital admission, the report indicates. At both 30 and 90 days, mortality was significantly lower in statin users than in non-statin users: 10.3% vs. 15.7% and 16.8% vs. 22.4%, respectively. The corresponding mortality rate ratios were 0.69 and 0.75. The risk reduction seen with statin use also held on a number of subanalyses.

By contrast, the researchers found no evidence that former use of statins or use of other cardiovascular agents provided any survival benefit from pneumonia.

Current statin use was also associated with a reduction in the risk of pulmonary complications (relative risk = 0.69). Statin use was, however, linked to a slight increase in the risk of bacteremia (RR = 1.07).

“Our study adds to the accumulating evidence that statin use is associated with improved prognosis after severe infections,” Dr. Thomsen and colleagues conclude. “The decrease in mortality associated with statin use seems to be substantial in patients with pneumonia requiring hospitalization.”

The present findings are “consistent with mechanisms of statin action on reducing G protein-mediated inflammation and infection,” Dr. Kasturi Haldar, from the University of Notre Dame, Indiana, writes in a related editorial. “It raises the question of whether statins should be used to improve anti-infective therapy.”

Reference:
Arch Intern Med 2008;168:2067-2068,2081-2087.