tetano
Editor, Senior Moderator
Am J Med Sci. 2013 Feb 19. [Epub ahead of print]
The Effect of Statin Therapy on the Incidence of Infections: A Retrospective Cohort Analysis.
Magulick JP, Frei CR, Ali SK, Mortensen EM, Pugh MJ, Oramasionwu CU, Daniels KR, Mansi IA.
Source
Department of Internal Medicine (JPM, SKA), San Antonio Military Medical Center, San Antonio, Texas; College of Pharmacy (CRF, KRD), The University of Texas at Austin, Austin, Texas; Pharmacotherapy Education and Research Center (CRF, KRD), School of Medicine, University of Texas Health Science Center, San Antonio, Texas; VA North Texas Health Care System (EMM); University of Texas Southwestern Medical Center (EMM), Dallas, Texas; South Texas Veterans Health Care System (MJP); Department of Epidemiology and Biostatistics (MJP), University of Texas Health Science Center, San Antonio, Texas; Division of Pharmaceutical Outcomes and Policy (CUO), UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina; Brooke Army Medical Center (IAM); and Uniformed Service University of Health Sciences (IAM); University of Texas Health Science Center, San Antonio, Texas (IAM).
Abstract
BACKGROUND:: Statins have been postulated to prevent infection through immunomodulatory effects. OBJECTIVES:: To compare the incidence of infections in statin users to that in nonusers within the same health care system. METHODS:: This was a retrospective cohort study of patients enrolled as Tricare Prime or Plus in the San Antonio military multimarket. Statin users were patients who received a statin for at least 3 months between October 1, 2004 and September 30, 2005. Nonusers were patients who did not receive a statin within the study period (October 1, 2003-September 30, 2009). Inpatient and outpatient International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes were used to determine the incidence of infections during the follow-up period (October 1, 2005-September 30, 2009) via multivariable regression analysis and time to infection via Cox regression analysis. RESULTS:: Of 45,247 patients who met the study criteria, 12,981 (29%) were statin users and 32,266 were nonusers. After adjustments for age, gender, Charlson Comorbidity Score, tobacco use, alcohol abuse/dependence, health care utilization and use of specific medication classes, statin use was associated with an increased incidence of common infections (odds ratio [OR]: 1.13; 95% confidence interval [CI]: 1.06-1.19) but not influenza or fungal infections (OR: 1.06, 95% CI: 0.80-1.39; OR: 0.97; 95% CI: 0.91-1.04, respectively). Time-to-first infection was similar in statin users and nonusers in all infection categories examined. CONCLUSIONS:: Statin use was associated with an increased incidence of common infections but not influenza or fungal infections. This study does not support a protective role of statins in infection prevention; however, the influence of potential confounders cannot be excluded.
PMID:
23426088
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23426088
The Effect of Statin Therapy on the Incidence of Infections: A Retrospective Cohort Analysis.
Magulick JP, Frei CR, Ali SK, Mortensen EM, Pugh MJ, Oramasionwu CU, Daniels KR, Mansi IA.
Source
Department of Internal Medicine (JPM, SKA), San Antonio Military Medical Center, San Antonio, Texas; College of Pharmacy (CRF, KRD), The University of Texas at Austin, Austin, Texas; Pharmacotherapy Education and Research Center (CRF, KRD), School of Medicine, University of Texas Health Science Center, San Antonio, Texas; VA North Texas Health Care System (EMM); University of Texas Southwestern Medical Center (EMM), Dallas, Texas; South Texas Veterans Health Care System (MJP); Department of Epidemiology and Biostatistics (MJP), University of Texas Health Science Center, San Antonio, Texas; Division of Pharmaceutical Outcomes and Policy (CUO), UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina; Brooke Army Medical Center (IAM); and Uniformed Service University of Health Sciences (IAM); University of Texas Health Science Center, San Antonio, Texas (IAM).
Abstract
BACKGROUND:: Statins have been postulated to prevent infection through immunomodulatory effects. OBJECTIVES:: To compare the incidence of infections in statin users to that in nonusers within the same health care system. METHODS:: This was a retrospective cohort study of patients enrolled as Tricare Prime or Plus in the San Antonio military multimarket. Statin users were patients who received a statin for at least 3 months between October 1, 2004 and September 30, 2005. Nonusers were patients who did not receive a statin within the study period (October 1, 2003-September 30, 2009). Inpatient and outpatient International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes were used to determine the incidence of infections during the follow-up period (October 1, 2005-September 30, 2009) via multivariable regression analysis and time to infection via Cox regression analysis. RESULTS:: Of 45,247 patients who met the study criteria, 12,981 (29%) were statin users and 32,266 were nonusers. After adjustments for age, gender, Charlson Comorbidity Score, tobacco use, alcohol abuse/dependence, health care utilization and use of specific medication classes, statin use was associated with an increased incidence of common infections (odds ratio [OR]: 1.13; 95% confidence interval [CI]: 1.06-1.19) but not influenza or fungal infections (OR: 1.06, 95% CI: 0.80-1.39; OR: 0.97; 95% CI: 0.91-1.04, respectively). Time-to-first infection was similar in statin users and nonusers in all infection categories examined. CONCLUSIONS:: Statin use was associated with an increased incidence of common infections but not influenza or fungal infections. This study does not support a protective role of statins in infection prevention; however, the influence of potential confounders cannot be excluded.
PMID:
23426088
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23426088