Continuation of statin therapy in patients with presumed infection: A randomized controlled trial

Kruger, Peter S., Harward, Meg L., Jones, Mark A., Joyce, Christopher J., Kostner, Karam M., Roberts, Michael S. and Venkateshm Bala (2011) Continuation of statin therapy in patients with presumed infection: A randomized controlled trial. American Journal of Respiraty and Critical Care Medicine, 183 6: 774-781. doi:10.1164/rccm.201006-0955OC


Author Kruger, Peter S.
Harward, Meg L.
Jones, Mark A.
Joyce, Christopher J.
Kostner, Karam M.
Roberts, Michael S.
Venkateshm Bala
Title Continuation of statin therapy in patients with presumed infection: A randomized controlled trial
Journal name American Journal of Respiraty and Critical Care Medicine   Check publisher's open access policy
ISSN 1073-449X
1535-4970
Publication date 2011-03-15
Year available 2010
Sub-type Article (original research)
DOI 10.1164/rccm.201006-0955OC
Volume 183
Issue 6
Start page 774
End page 781
Total pages 8
Place of publication New York, NY, U.S.A.
Publisher American Thoracic Society
Collection year 2011
Language eng
Formatted abstract
Rationale: In patients on prior statin therapy who are hospitalized for acute infections, current literature is unclear on whether statins should be continued during their hospitalization.

Objectives: To test the hypothesis that continuation of therapy with statins influences the inflammatory response to infection and that cessation may cause an inflammatory rebound.

Methods:
Prospective randomized double-blind placebo-controlled trial of atorvastatin (20 mg) or matched placebo in 150 patients on preexisting statin therapy requiring hospitalization for infection.

Measurements and Main Results: The primary end point was progression of sepsis during hospitalization. At baseline, the rate of severe sepsis was 32% in both groups. Compared with baseline, the odds ratio for severe sepsis declined in both groups: 0.43 placebo and 0.5 statins (Day 3) versus 0.14 placebo and 0.12 statins (Day 14). The rate of decline of severe sepsis was similar between the groups (odds ratio 1.17 [0.56–2.47], P = 0.7 Day 3; 0.85 [0.21–3.34], P = 0.8 Day 14). IL-6 and C-reactive protein declined in both groups with no statistically significant difference (P = 0.7 and P = 0.2, respectively). An increase in cholesterol occurred in the placebo group (P < 0.0001). Most patients were not critically ill. Hospital mortality was 6.6%, with no difference between the groups (6 [8%] of 75 statin group; 4 [5.3%] of 75 placebo group; P = 0.75).

Conclusions: This study does not support a beneficial role of continuing preexisting statin therapy on sepsis and inflammatory parameters. Cessation of established statin therapy was not associated with an inflammatory rebound.
Copyright © 2011 by the American Thoracic Society
Keyword Statin
HMG Co A reductase inhibitor
Sepsis
Infection
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published ahead of print on October 19, 2010

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
School of Medicine Publications
 
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Created: Fri, 18 Mar 2011, 15:08:53 EST by Debbie Banks on behalf of School of Medicine