Statins and outcome after hospitalization for COPD exacerbation: A prospective study

被引：54

作者：

Bartziokas, Konstantinos ^{[1
,2
]}

Papaioannou, Andriana I. ^{[1
]}

Minas, Markos ^{[1
]}

Kostikas, Konstantinos ^{[1
]}

Banya, Winston ^{[3
]}

Daniil, Zoe D. ^{[1
]}

Haniotou, Aikaterini ^{[2
]}

Gourgoulianis, Konstantinos I. ^{[1
]}

机构：

[1] Univ Thessaly Med Sch, Dept Resp Med, Larisa, Greece

[2] Amalia Fleming Hosp, Dept Resp Med, Athens, Greece

[3] Royal Brompton & Harefield NHS Trust, London SW3 6NP, England

来源：

PULMONARY PHARMACOLOGY & THERAPEUTICS | 2011年 / 24卷 / 05期

关键词：

COPD; Statins; Cardiovascular comorbidities; Mortality; COPD exacerbations; Health-related quality of life; OBSTRUCTIVE PULMONARY-DISEASE; COA REDUCTASE INHIBITORS; QUALITY-OF-LIFE; SYSTEMIC INFLAMMATION; INCREASED RISK; LUNG-FUNCTION; HEALTH-STATUS; MORTALITY; MORBIDITY; COMORBIDITIES;

D O I：

10.1016/j.pupt.2011.06.003

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Background: Retrospective studies have shown that the use of statins is associated with reduced mortality and decreased hospitalizations from COPD, but data from prospective studies are lacking. Methods: We followed-up prospectively 245 patients admitted to hospital for exacerbations of COPD (ECOPD) with monthly evaluations for one year. The role of statins on outcomes was evaluated by Cox regression analysis after proper adjustments for age, gender, BMI, current smoking status, Charlson comorbidity index and COPD stage. Health-related quality of life (HRQoL) was evaluated by Saint George's Respiratory Questionnaire. Results: There was no effect of statins on either 30-day or 1-year mortality. Patients receiving statins presented a lower total number of ECOPD during the 1-year follow up (2.1 +/- 2.7 vs. 2.8 +/- 3.2 ECOPD/patient respectively, p = 0.037). After proper adjustments, the use of statins was associated with a lower risk for ECOPD [HR: 0.656 (95% CI: 0.454-0.946)] and severe ECOPD [HR: 0.608 (95%CI: 0.381-0.972)]. The group of statins presented better improvement in HRQoL at 2, 6 and 12 months (p < 0.001). Conclusions: The use of statins in patients hospitalized for ECOPD was associated with a lower risk for subsequent ECOPD and severe ECOPD and improved HRQoL These data support a possible beneficial role for these agents in COPD. (C) 2011 Elsevier Ltd. All rights reserved.

引用

页码：625 / 631

页数：7

共 36 条

[21] Reduction of morbidity and mortality by statins, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers in patients with chronic obstructive pulmonary disease [J].

Mancini, G. B. John ;

Etminan, Mahyar ;

Zhang, Bin ;

Levesque, Linda E. ;

FitzGerald, J. Mark ;

Brophy, James M. .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2006, 47 (12) :2554-2560

[22] Predictors of rehospitalization and death after a severe exacerbation of COPD [J].

McGhan, Ryan ;

Radcliff, Tiffany ;

Fish, Ron ;

Sutherland, E. Rand ;

Welsh, Carolyn ;

Make, Barry .

CHEST, 2007, 132 (06) :1748-1755

[23] Factors associated with increased risk of exacerbation and hospital admission in a cohort of ambulatory COPD patients:: A multiple logistic regression analysis [J].

Miravitlles, M ;

Guerrero, T ;

Mayordomo, C ;

Sánchez-Agudo, L ;

Nicolau, F ;

Segú, JL .

RESPIRATION, 2000, 67 (05) :495-501

[24] Impact of statins and ACE inhibitors on mortality after COPD exacerbations [J].

Mortensen, Eric M. ;

Copeland, Laurel A. ;

Pugh, Mary Jo V. ;

Restrepo, Marcos I. ;

de Molina, Rosa Malo ;

Nakashima, Brandy ;

Anzueto, Antonio .

RESPIRATORY RESEARCH, 2009, 10

[25] Global assessment of the COPD patient: Time to look beyond FEV1? [J].

Papaioannou, Andrianal I. ;

Loukides, Stelios ;

Gourgoulianis, Konstantinos I. ;

Kostikas, Konstantinos .

RESPIRATORY MEDICINE, 2009, 103 (05) :650-660

[26] Relationship between bacterial colonisation and the frequency, character, and severity of COPD exacerbations [J].

Patel, IS ;

Seemungal, TAR ;

Wilks, M ;

Lloyd-Owen, SJ ;

Donaldson, GC ;

Wedzicha, JA .

THORAX, 2002, 57 (09) :759-764

[27] Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease - GOLD executive summary [J].

Rabe, Klaus F. ;

Hurd, Suzanne ;

Anzueto, Antonio ;

Barnes, Peter J. ;

Buist, Sonia A. ;

Calverley, Peter ;

Fukuchi, Yoshinosuke ;

Jenkins, Christine ;

Rodriguez-Roisin, Roberto ;

van Weel, Chris ;

Zielinski, Jan .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2007, 176 (06) :532-555

[28] β-Blockers May Reduce Mortality and Risk of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease [J].

Rutten, Frans H. ;

Zuithoff, Nicolaas P. A. ;

Hak, Eelko ;

Grobbee, Diederick E. ;

Hoes, Arno W. .

ARCHIVES OF INTERNAL MEDICINE, 2010, 170 (10) :880-887

[29] Inflammation, immunity, and HMG-CoA reductase inhibitors -: Statins as antiinflammatory agents? [J].

Schönbeck, U ;

Libby, P .

CIRCULATION, 2004, 109 (21) :18-26

[30] Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease [J].

Seemungal, TAR ;

Donaldson, GC ;

Paul, EA ;

Bestall, JC ;

Jeffries, DJ ;

Wedzicha, JA .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1998, 157 (05) :1418-1422

← 1 2 3 4 →