Chest
Volume 131, Issue 4, April 2007, Pages 1006-1012
Journal home page for Chest

Original Research
Novel Pharmacotherapy
Influenza and COPD Mortality Protection as Pleiotropic, Dose-Dependent Effects of Statins

https://doi.org/10.1378/chest.06-1997Get rights and content

Background

Published data on antiinflammatory and immunomodulatory effects of statins suggest they may reduce mortality risks associated with an unchecked immune response to selected infections, including influenza and COPD. We assessed whether statin users had reduced mortality risks from these conditions.

Methods

We conducted a matched cohort study (n = 76,232) and two separate case-control studies (397 influenza and 207 COPD deaths) to evaluate whether statin therapy is associated with increased or decreased mortality risk and survival time using health-care encounter data for members of health maintenance organizations. For the cohort study, baseline illness risks from all causes prior to initiation of statin therapy were used to statistically adjust for the occurrence of outcomes after initiation of treatment.

Results

For moderate-dose (≥ 4 mg/d) statin users, this cohort study found statistically significant reduced odds ratios (ORs) of influenza/pneumonia death (OR, 0.60; 95% confidence interval [CI], 0.44 to 0.81) and COPD death (OR, 0.17; 95% CI, 0.07 to 0.42) and similarly reduced survival hazard ratios. Findings were confirmed with the case-control studies. Confounding factors not considered may explain some of the effects observed.

Conclusions

This study found a dramatically reduced risk of COPD death and a significantly reduced risks of influenza death among moderate-dose statin users.

Section snippets

Materials and Methods

We conducted a matched cohort study and two case-control studies to evaluate whether statin use is associated with a reduced risk of death from pneumonia/influenza or COPD. For the case-control studies, two groups of cases and control subjects were selected based on two outcomes: pneumonia/influenza and COPD. This research protocol was reviewed and ruled exempt under the Code of Federal Regulations protection of human subjects.29 The Lovelace Patient Database (LPD), a deidentified,

Matched Cohort Study

Table 1 lists the characteristics of the patients in the matched cohort. Among the 19,058 HMO members with a statin pharmacy fill, 11,583 patients (60.8%) received at least 4 mg/d during phase 2. Statin daily dose was lowest in members born after 1945 (p < 0.001). Statin users had a higher mean number of different medications received in phase 1. A higher fraction of moderate-daily-dose users (≥ 4 mg/d) had three or more influenza vaccinations in phase 2. Significantly more statin users (both

Discussion

This study found a dramatically reduced risk of death from COPD among statin users and a significantly reduced risk of death from influenza/pneumonia. Since the reductions were observed in both the cohort and case-control studies, it is unlikely they could be due to artifacts of either study design or the analysis.

These findings suggest that moderate-dose statin use reduces the risk of influenza/pneumonia death and strongly suggest that statins reduce the risk of COPD death. Both findings are

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  • Cited by (0)

    This work was performed at Lovelace Respiratory Research Institute.

    The authors have no conflicts of interest to disclose.

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