Association Between Use of Statins and Mortality Among Patients Hospitalized With Laboratory-Confirmed Influenza Virus Infections: A Multistate Study

[tetano]

J Infect Dis. (2011) doi: 10.1093/infdis/jir695 First published online: December 13, 2011

Association Between Use of Statins and Mortality Among Patients Hospitalized With Laboratory-Confirmed Influenza Virus Infections: A Multistate Study

Meredith L. Vandermeer1,
Ann R. Thomas1,
Laurie Kamimoto2,
Arthur Reingold3,
Ken Gershman4,
James Meek5,
Monica M. Farley6,
Patricia Ryan7,
Ruth Lynfield8,
Joan Baumbach9,
William Schaffner10,
Nancy Bennett11 and
Shelley Zansky12

+ Author Affiliations

1Oregon Public Health Division, Portland
2Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
3California Emerging Infections Program, Oakland
4Colorado Department of Public Health and Environment, Denver
5Connecticut Emerging Infections Program, New Haven
6Emory University School of Medicine and the VA Medical Center, Atlanta, Georgia
7Maryland Department of Health and Mental Hygiene, Baltimore
8Minnesota Department of Health, St Paul
9New Mexico Department of Health, Santa Fe
10Vanderbilt University School of Medicine, Nashville, Tennessee
11University of Rochester School of Medicine and Dentistry, New York
12New York State Department of Health, Emerging Infections Program, Albany

Correspondence: Ann Thomas, MD, MPH, Oregon Public Health Division, 800 NE Oregon St, Portland, OR 97212 (ann.thomas@state.or.us).

Abstract

ARTICLE

Background. Statins may have anti-inflammatory and immunomodulatory effects that could reduce the risk of mortality from influenza virus infections.

Methods. The Centers for Disease Control and Prevention’s Emerging Infections Program conducts active surveillance for persons hospitalized with laboratory-confirmed influenza in 59 counties in 10 states. We analyzed data for hospitalized adults during the 2007–2008 influenza season to evaluate the association between receiving statins and influenza-related death.

Results. We identified 3043 patients hospitalized with laboratory-confirmed influenza, of whom 1013 (33.3%) received statins and 151 (5.0%) died within 30 days of their influenza test. Patients who received statins were more likely to be older, male, and white; to suffer from cardiovascular, metabolic, renal, and chronic lung disease; and to have been vaccinated against influenza that season. In a multivariable logistic regression model, administration of statins prior to or during hospitalization was associated with a protective odds of death (adjusted odds ratio, 0.59 [95% confidence interval, .38–.92]) when adjusting for age; race; cardiovascular, lung, and renal disease; influenza vaccination; and antiviral administration.

Conclusions. Statin use may be associated with reduced mortality in patients hospitalized with influenza.

http://jid.oxfordjournals.org/conte...ract?sid=d6c5ab6b-8a19-411c-9ff2-ff10835c5719

 

[tetano]

Re: Association Between Use of Statins and Mortality Among Patients Hospitalized With Laboratory-Confirmed Influenza Virus Infections: A Multistate Study

J Infect Dis. (2011) doi: 10.1093/infdis/jir693 First published online: December 13, 2011

Statins and Influenza: Can We Move Forward?

Edward E. Walsh

+ Author Affiliations

Infectious Diseases Division, University of Rochester School of Medicine and the Rochester General Hospital, New York

Correspondence: Edward E. Walsh, MD, Infectious Diseases Division, Rochester General Hospital, 1425 Portland Ave, Rochester, New York 14621 (edward.walsh@rochestergeneral.org).

ARTICLE

Currently, the 2 main strategies for control of influenza are immunization and antiviral drugs. However, despite increasing uptake of influenza vaccine among the highest risk groups—namely, the elderly and persons with underlying cardiopulmonary diseases—morbidity and mortality from influenza continues to rise in the United States [1]. This paradox has stimulated a heated debate regarding the true efficacy of influenza vaccination in older persons [2, 3]. Some investigators suggest efficacy may be negligible in this group, and even the most optimistic proponents of immunization concede that the current licensed standard dose of inactivated vaccine is less immunogenic and protective in older persons than in young healthy persons [4, 5, 6]. Antiviral therapy, principally with neuraminidase inhibitors, has been shown repeatedly in placebo-controlled trials to be effective when administered to both young and old outpatients early in the course of illness [7, 8]. Although controlled studies in inpatients are strikingly absent, one observational analysis from Toronto noted a 79% reduction in mortality in patients treated with a neuraminidase inhibitor, even when administered after the 48-hour window following symptom onset [9]. Despite availability of vaccine and antivirals, additional therapeutic measures for influenza would be welcomed.

In this issue of the Journal, Vandermeer and collaborators report that statin use is associated with reduced mortality during and after hospitalization with influenza infection [10]. The investigators analyzed 30-day mortality in 3043 patients hospitalized with influenza in 10 states as part of the Centers for Disease Control and Prevention’s Emerging Infections Program. After adjusting for other variables, such as age, underlying medical conditions, and influenza vaccination, they reported a striking 41% reduction in mortality (odds ratio, 0.59 [95% confidence interval, .38–.92]) in persons on statins either prior to or …

 

[Laidback Al]

Re: Association Between Use of Statins and Mortality Among Patients Hospitalized With Laboratory-Confirmed Influenza Virus Infections: A Multistate Study

J Infect Dis. (2011) doi: 10.1093/infdis/jir695 First published online: December 13, 2011

Association Between Use of Statins and Mortality Among Patients Hospitalized With Laboratory-Confirmed Influenza Virus Infections: A Multistate Study

full article available at this link -

http://www.oxfordjournals.org/our_journals/jid/prpaper.pdf

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