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

Bartziokas, Κonstantinos; Papaioannou, Andriana Ι.; Minas, Markos; Banya, Winston; Daniil, Zoe; Haniotou, Aikaterini; Gourgoulianis, Konstantinos

doi:10.1016/j.pupt.2011.06.003

Cited by 59 publications

(49 citation statements)

References 34 publications

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“…The design of this study (monthly telephone communication) may not have allowed for objective evaluation of the indications for COPD hospitalisation during follow-up. Our study involved patients with a male:female ratio of ,9:1; however, this was also the case in previous studies by our group with a similar design [39,40], and may reflect the increased prevalence of COPD in males compared with females in Greece [41]. However, the fact that a simple measure of depressive symptoms, such as the BDI, was a significant predictor of clinically important future outcomes in hospitalised COPD patients supports a possible usefulness for this measure in clinical practice.…”

Section: Discussionmentioning

confidence: 83%

The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations

et al. 2012

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The impact of depressive symptoms on outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) has not been thoroughly evaluated in prospective studies.We prospectively enrolled 230 consecutive patients hospitalised for AECOPD, without previous diagnosis of depression. Depressive symptoms were evaluated with Beck's depression inventory. Pulmonary function tests, arterial blood gases, COPD assessment test (CAT) and Borg dyspnoea scale were recorded on admission and on days 3, 10 and 40. Patients were evaluated monthly for 1 year.Patients with depressive symptoms required longer hospitalisation (mean¡SD 11.6¡3.7 versus 5.6¡4.1 days, p,0.001). Clinical variables improved during the course of AECOPD, but depressive symptoms on admission had a significant impact on dyspnoea (p,0.001) and CAT score (p50.012) improvement. Patients with depressive symptoms presented more AECOPD (p,0.001) and more hospitalisations for AECOPD (p,0.001) in 1 year. In multivariate analysis, depressive symptoms were an independent predictor of mortality (hazard ratio 3.568, 95% CI 1.302-9.780) and risk for AECOPD (incidence rate ratio (IRR) 2.221, 95% CI 1.573-3.135) and AECOPD hospitalisations (IRR 3.589, 95% CI 2.319-5.556) in 1 year.The presence of depressive symptoms in patients admitted for AECOPD has a significant impact on recovery and is related to worse survival and increased risk for subsequent COPD exacerbations and hospitalisations in 1 year.

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Section: Discussionmentioning

confidence: 83%

The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations

et al. 2012

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“…13 A further prospective observational study observed a 34%-40% lower risk of subsequent COPD exacerbation by statin use versus nonuse. 14 However, these studies were subjected to categorization of statin use based on a single prescription, 12,13 lack of adjustment for COPD severity and other important confounders (eg, respiratory antibiotics), 12-15 potential for confounding by indication, 14 immortal time bias, 13,15 and immeasurable time bias. 12 These limitations were addressed in our study.…”

Section: Discussionmentioning

confidence: 99%

“…11 Additionally, recent observational studies reported a 28%-40% reduced risk of COPD hospitalizations [12][13][14] and 10-fold decrease in the risk for intubation, 15 as well as 54%-71% decreased mortality risk associated with statin use in COPD patients. [16][17][18] However, these studies were hampered by either small sample size, 14,15,17 incomprehensive statin measurement, 13,16 inadequate adjustment for confounding, [13][14][15] immeasurable bias, 12,19 or immortal time bias. 13,[17][18][19] Consequently, whether use of statins exerts a beneficial effect on COPD exacerbations remains unclear.…”

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confidence: 99%

Statin Use and Risk of COPD Exacerbation Requiring Hospitalization

Wang

Tsai

et al. 2013

The American Journal of Medicine

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“…Predominantly observational evidence about the effects of statins in COPD suggested that statins are associated with a lower rate of FEV1 decline [174], decreased airflow limitation [175], fewer re-hospitalisations due to COPD [176], reduced cardiovascular morbidity and mortality [177,178], decreased all-cause mortality [177,178], and improved exercise tolerance and dyspnoea among patients with coexisting hypertension [179]. However, the National Institutes of Health and Canadian Institute of Health Research subsequently reported the results of a randomised trial that compared regular use of simvastatin with placebo, the STATCOPE study.…”

Section: Statin Therapymentioning

confidence: 99%

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD

et al. 2015

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Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) research statement is to describe evidence related to diagnosis, assessment and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management.Clinicians, researchers, and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified.Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus.Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ ERS research statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centred outcomes. @ERSpublications ATS/ERS statement: which types of research will have the greatest future impact on patientcentred outcomes in COPD? http://ow.ly/I54Hb

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

Cited by 59 publications

References 34 publications

The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations

The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations

Statin Use and Risk of COPD Exacerbation Requiring Hospitalization

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD

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