Statins reduce all-cause mortality risk in COPD
medwireNews: Results from a Dutch study suggest that treatment with statins reduces all-cause mortality in patients with chronic obstructive pulmonary disease (COPD), particularly in those with higher levels of systemic inflammation.
Bruno Stricker (Erasmus University Medical Center, Rotterdam) and colleagues found that long-term statin treatment (>2 years) was associated with an overall 39% reduced risk for all-cause mortality in middle-aged or older COPD patients, compared with no treatment.
Among COPD patients with high-sensitivity C-reactive protein (hsCRP) levels above 3 mg/L, long-term statin use was associated with a significant 78% reduced risk for all-cause mortality compared with non use.
By contrast, among COPD patients with hsCRP levels of 3 mg/L or lower, long-term statin use was associated with a nonsignificant 21% reduced risk for all-cause mortality.
The reduced risk for all-cause mortality associated with statin use was independent of age, gender, other drug use, COPD duration, smoking pack-years, total serum cholesterol, body mass index, and cardiovascular covariables, the researchers note.
Regarding cause-specific mortality, statin use for more than 30 days was associated with a trend toward a reduced risk for pulmonary and cardiovascular mortality, but was not associated with cancer mortality.
"These results suggest that in an older population of COPD patients, CRP levels might guide the clinician better than total cholesterol levels in his decision to start lipid lowering therapy," comment the researchers in Pulmonary Pharmacology and Therapeutics.
The team analyzed data from the Rotterdam Study, a population-based cohort study involving 7983 individuals aged 55 years or older.
Automated pharmacy records were used to compare statin use between 363 COPD patients who died during the 17-year follow-up period and 2345 age- and gender-matched COPD patients who survived the follow-up period of the index case.
Among the COPD patients who died, the most frequent causes of death were cardiovascular (38.3%), pulmonary complications of COPD (19.6%), such as exacerbations, emphysema or pneumonia, and bronchial carcinoma (10.5%).
Stricker et al conclude: "Statin use is associated with a decreased risk of all-cause mortality in patients with COPD, depending on the degree of systemic inflammation."
They add: "This study may provide a rationale for undertaking more definitive randomized clinical trials to confirm the impact of statin use on the outcome of COPD and to elucidate the mechanisms by which they may work."
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By Mark Cowen, Senior medwireNews Reporter