Effect of the use of low and high potency statins and sepsis outcomes

Shu Yu Ou, Hsi Chu, Pei Wen Chao, Shuo Ming Ou, Yi Jung Lee, Shu Chen Kuo, Szu Yuan Li, Chia Jen Shih, Yung Tai Chen

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Introduction: Although statins have been shown to have cholesterol-lowering effects, their pleiotropic benefits on sepsis remain a matter of debate. In addition, the influence of statin potency on sepsis-related mortality has never been explored. The aim of our study was to determine the sepsis outcomes of low- and high-potency statin users and non-users.

Methods: This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan’s National Health Insurance program. Patients were hospitalized for sepsis between 2000 and 2010. All-cause mortality and major adverse consequences of sepsis, such as in-hospital death, intensive care unit admission, shock events, and the use of mechanical ventilation, were assessed. Patients were divided into high-potency statin users (at least 10 mg rosuvastatin, at least 20 mg atorvastatin, or at least 40 mg simvastatin), low-potency statin users (all other statin treatments), and non-users.

Results: A propensity score-matched cohort of 27,792 statin users and 27,792 non-users was included. Of 27,792 statin users, 9,785 (35.2 %) were treated with high-potency statins and 18,007 (64.8 %) were treated with low-potency statins. The 1-year mortality risk was significantly lower among both low-potency [adjusted hazard ratio (aHR) 0.89, 95 % confidence interval (CI) 0.85–0.93] and high-potency (aHR 0.80, 95 % CI 0.75–0.86) statin users compared with non-users. The risks of mortality and adverse consequences of sepsis were lower among high-potency than among low-potency statin users.

Conclusions: High-potency statin use is associated with a lower risk of sepsis-related mortality compared with low-potency statin use.

Original languageEnglish
Pages (from-to)1509-1517
Number of pages9
JournalIntensive Care Medicine
Volume40
Issue number10
DOIs
Publication statusPublished - Sep 26 2014

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Sepsis
Mortality
Propensity Score
National Health Programs
Confidence Intervals
Simvastatin
Artificial Respiration

Keywords

  • Mortality
  • National Health Insurance Research Database
  • Potency
  • Sepsis
  • Statin

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Ou, S. Y., Chu, H., Chao, P. W., Ou, S. M., Lee, Y. J., Kuo, S. C., ... Chen, Y. T. (2014). Effect of the use of low and high potency statins and sepsis outcomes. Intensive Care Medicine, 40(10), 1509-1517. https://doi.org/10.1007/s00134-014-3418-1

Effect of the use of low and high potency statins and sepsis outcomes. / Ou, Shu Yu; Chu, Hsi; Chao, Pei Wen; Ou, Shuo Ming; Lee, Yi Jung; Kuo, Shu Chen; Li, Szu Yuan; Shih, Chia Jen; Chen, Yung Tai.

In: Intensive Care Medicine, Vol. 40, No. 10, 26.09.2014, p. 1509-1517.

Research output: Contribution to journalArticle

Ou, SY, Chu, H, Chao, PW, Ou, SM, Lee, YJ, Kuo, SC, Li, SY, Shih, CJ & Chen, YT 2014, 'Effect of the use of low and high potency statins and sepsis outcomes', Intensive Care Medicine, vol. 40, no. 10, pp. 1509-1517. https://doi.org/10.1007/s00134-014-3418-1
Ou, Shu Yu ; Chu, Hsi ; Chao, Pei Wen ; Ou, Shuo Ming ; Lee, Yi Jung ; Kuo, Shu Chen ; Li, Szu Yuan ; Shih, Chia Jen ; Chen, Yung Tai. / Effect of the use of low and high potency statins and sepsis outcomes. In: Intensive Care Medicine. 2014 ; Vol. 40, No. 10. pp. 1509-1517.
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AU - Chu, Hsi

AU - Chao, Pei Wen

AU - Ou, Shuo Ming

AU - Lee, Yi Jung

AU - Kuo, Shu Chen

AU - Li, Szu Yuan

AU - Shih, Chia Jen

AU - Chen, Yung Tai

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N2 - Introduction: Although statins have been shown to have cholesterol-lowering effects, their pleiotropic benefits on sepsis remain a matter of debate. In addition, the influence of statin potency on sepsis-related mortality has never been explored. The aim of our study was to determine the sepsis outcomes of low- and high-potency statin users and non-users.Methods: This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan’s National Health Insurance program. Patients were hospitalized for sepsis between 2000 and 2010. All-cause mortality and major adverse consequences of sepsis, such as in-hospital death, intensive care unit admission, shock events, and the use of mechanical ventilation, were assessed. Patients were divided into high-potency statin users (at least 10 mg rosuvastatin, at least 20 mg atorvastatin, or at least 40 mg simvastatin), low-potency statin users (all other statin treatments), and non-users.Results: A propensity score-matched cohort of 27,792 statin users and 27,792 non-users was included. Of 27,792 statin users, 9,785 (35.2 %) were treated with high-potency statins and 18,007 (64.8 %) were treated with low-potency statins. The 1-year mortality risk was significantly lower among both low-potency [adjusted hazard ratio (aHR) 0.89, 95 % confidence interval (CI) 0.85–0.93] and high-potency (aHR 0.80, 95 % CI 0.75–0.86) statin users compared with non-users. The risks of mortality and adverse consequences of sepsis were lower among high-potency than among low-potency statin users.Conclusions: High-potency statin use is associated with a lower risk of sepsis-related mortality compared with low-potency statin use.

AB - Introduction: Although statins have been shown to have cholesterol-lowering effects, their pleiotropic benefits on sepsis remain a matter of debate. In addition, the influence of statin potency on sepsis-related mortality has never been explored. The aim of our study was to determine the sepsis outcomes of low- and high-potency statin users and non-users.Methods: This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan’s National Health Insurance program. Patients were hospitalized for sepsis between 2000 and 2010. All-cause mortality and major adverse consequences of sepsis, such as in-hospital death, intensive care unit admission, shock events, and the use of mechanical ventilation, were assessed. Patients were divided into high-potency statin users (at least 10 mg rosuvastatin, at least 20 mg atorvastatin, or at least 40 mg simvastatin), low-potency statin users (all other statin treatments), and non-users.Results: A propensity score-matched cohort of 27,792 statin users and 27,792 non-users was included. Of 27,792 statin users, 9,785 (35.2 %) were treated with high-potency statins and 18,007 (64.8 %) were treated with low-potency statins. The 1-year mortality risk was significantly lower among both low-potency [adjusted hazard ratio (aHR) 0.89, 95 % confidence interval (CI) 0.85–0.93] and high-potency (aHR 0.80, 95 % CI 0.75–0.86) statin users compared with non-users. The risks of mortality and adverse consequences of sepsis were lower among high-potency than among low-potency statin users.Conclusions: High-potency statin use is associated with a lower risk of sepsis-related mortality compared with low-potency statin use.

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