Impact of statins and angiotensin-converting enzyme inhibitors on mortality of subjects hospitalised with pneumonia

• Published in: The European respiratory journal Vol. 31; no. 3; pp. 611 - 617
• Main Authors: Mortensen, E. M, Pugh, M. J, Copeland, L. A, Restrepo, M. I, Cornell, J. E, Anzueto, A, Pugh, J. A
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01.03.2008; Maney
• Subjects: Aged; Aged, 80 and over; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Biological and medical sciences; Case-Control Studies; Community-Acquired Infections - mortality; Female; Hospital Mortality; Hospitals, Veterans - statistics & numerical data; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Male; Medical sciences; Odds Ratio; Pneumology; Pneumonia - complications; Pneumonia - mortality; Retrospective Studies; United States - epidemiology; United States; Human; Lung disease; Pneumonia; Prognosis; Enzyme; Respiratory disease; Mortality; Angiotensin-converting enzyme inhibitor; Statin derivative; Epidemiology; 3-hydroxl-3-methyl-glutaryl-CoA reductase inhibitor; Oxidoreductases; ACE inhibitor; Pneumology; Reductase
• ISSN: 0903-1936; 1399-3003; 1399-3003
• DOI: 10.1183/09031936.00162006

Recent studies suggest that statins and angiotensin-converting enzyme (ACE) inhibitors may have beneficial effects for some types of infections. The present study aimed to examine the association of outpatient use of these medications on 30-day mortality for subjects aged >65 yrs and hospitalised with community-acquired pneumonia. A retrospective national cohort study was conducted using the Department of Veterans Affairs administrative data including subjects aged ≥65 yrs hospitalised with community-acquired pneumonia, and having ≥1 yr of prior Veterans Affairs outpatient care. In total, 8,652 subjects were identified with a mean age of 75 yrs, 98.6% were male, and 9.9% of subjects died within 30 days of presentation. In this cohort, 18.1% of subjects were using statins and 33.9% were using ACE inhibitors. After adjusting for potential confounders, current statin use (odds ratio (OR) 0.54, 95% confidence interval (CI) 0.42–0.70) and ACE inhibitor use (OR 0.80, 95% CI 0.68–0.89) were significantly associated with decreased 30-day mortality. Use of statins and angiotensin-converting enzyme inhibitors prior to admission is associated with decreased mortality in subjects hospitalised with community-acquired pneumonia. Randomised controlled trials are needed to examine whether the use of these medications in patients hospitalised with community-acquired pneumonia may be beneficial.