The Effect of Statins Use on the Risk and Outcome of Acute Bacterial Infections in Adult Patients

Nassaji, Mohammad; Ghorbani, Raheb; Afshar, Reza Kiaee

doi:10.7860/jcdr/2015/14538.6773

Cited by 7 publications

(9 citation statements)

References 36 publications

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“…Prior use of statins could be associated with a reduced risk of post‐operative infections after cardiac surgery . Prior use of statins could be associated with shorter duration of hospitalization and lower rate of hospital mortality due to acute bacterial infections . These studies are compatible with our findings that prior use of statins may be associated with a reduced risk of infections.…”

Section: Discussionsupporting

confidence: 90%

“…To date, no other study have focused on the relationship between statin use and pyogenic liver abscess, and therefore, we cannot make comparisons. Epidemiological studies have shown that prior use of statins could be associated with a reduced risk of pneumonia and other acute bacterial infections . Prior use of statins could be associated with a reduced risk of post‐operative infections after cardiac surgery .…”

Section: Discussionmentioning

confidence: 99%

“…Clinically, statin use is very safe and well tolerated with only few adverse effects, including muscle‐related disorders (including myalgia, myositis and rhabdomyolysis), and usually asymptomatic elevation of liver enzymes . Beyond their well‐known cholesterol‐lowering property, recent evidence has drawn attention to the specific effects of statins on immunomodulation and anti‐inflammation, which may be associated with a protective effect on decreased likelihood of acute bacterial infections, and even with reduction in infection‐related mortality .…”

mentioning

confidence: 99%

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Statin Use Correlates with Reduced Risk of Pyogenic Liver Abscess: A Population‐Based Case–Control Study

Liao

Cheng

Lin

et al. 2017

Basic Clin Pharma Tox

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Little research is available on the relationship between statin use and pyogenic liver abscess. The objective of the study was to determine whether prior use of statins is associated with pyogenic liver abscess. This case-control study was conducted to analyse the claim data of the Taiwan National Health Insurance Program. There were 1828 participants aged 20-84 years with first episode of pyogenic liver abscess from 2000 to 2013 as the cases and 1828 randomly selected participants without pyogenic liver abscess matched with sex, age and index year as the controls. Statin use was defined as 'current', 'recent' or 'past' if the statin prescription was filled ≤3 months, 3-6 months or >6 months before the date of pyogenic liver abscess diagnosis, respectively. Relative risk of pyogenic liver abscess associated with statin use was estimated by the odds ratio (OR) with 95% confidence interval (CI) using the multivariable logistic regression model. After controlling for potential confounders, the adjusted ORs of pyogenic liver abscess were 0.65 for participants with current use of statins (95% CI 0.50, 0.84), 0.74 for participants with recent use of statins (95% CI 0.49, 1.11), and 1.10 for participants with past use of statins (95% CI 0.90, 1.34), compared with participants with never use of statins. In the further analysis, the adjusted ORs of pyogenic liver abscess were 0.65 for participants with cumulative duration of statin use ≥12 months (95% CI 0.48, 0.88) and 0.68 for participants with cumulative duration of statin use <12 months (95% CI 0.43, 1.07), compared with participants with never use of statins. Our findings provide strong evidence that patients with current use of statins are associated with a 35% reduced odds of pyogenic liver abscess. The protective effect is stronger for longer duration of statin use.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Statin Use Correlates with Reduced Risk of Pyogenic Liver Abscess: A Population‐Based Case–Control Study

Liao

Cheng

Lin

et al. 2017

Basic Clin Pharma Tox

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“…Of note, phagocytosis can also contribute to disease progression if internalized bacteria are not completely killed, and the bactericidal capacity of macrophages is linked to a proinflammatory phenotype [80]. Thus, the pro-inflammatory state induced by statins may contribute to a better outcome in bacterial infections, which was previously observed for patients on statin therapy [13,14]. Bempedoic acid, on the other hand, had negligible effects on inflammation, but even enhanced phagocytosis, at least in M2 macrophages.…”

Section: Discussionmentioning

confidence: 73%

“…Therefore, statins have been suggested for the treatment of respiratory conditions such as pneumonia and acute respiratory distress syndrome [11,12]. They have also been reported to be beneficial in different bacterial infections [13,14], and their benefits in the treatment of COVID-19 are currently under investigation [15]. Consistent clinical evidence for the benefits of statin use in a broader range of inflammatory conditions is lacking, which is why statins are still only approved for primary and secondary prevention of cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

Statins and Bempedoic Acid: Different Actions of Cholesterol Inhibitors on Macrophage Activation

Linnenberger

Hoppstädter

Wrublewsky

et al. 2021

IJMS

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Statins represent the most prescribed class of drugs for the treatment of hypercholesterolemia. Effects that go beyond lipid-lowering actions have been suggested to contribute to their beneficial pharmacological properties. Whether and how statins act on macrophages has been a matter of debate. In the present study, we aimed at characterizing the impact of statins on macrophage polarization and comparing these to the effects of bempedoic acid, a recently registered drug for the treatment of hypercholesterolemia, which has been suggested to have a similar beneficial profile but fewer side effects. Treatment of primary murine macrophages with two different statins, i.e., simvastatin and cerivastatin, impaired phagocytotic activity and, concurrently, enhanced pro-inflammatory responses upon short-term lipopolysaccharide challenge, as characterized by an induction of tumor necrosis factor (TNF), interleukin (IL) 1β, and IL6. In contrast, no differences were observed under long-term inflammatory (M1) or anti-inflammatory (M2) conditions, and neither inducible NO synthase (iNOS) expression nor nitric oxide production was altered. Statin treatment led to extracellular-signal regulated kinase (ERK) activation, and the pro-inflammatory statin effects were abolished by ERK inhibition. Bempedoic acid only had a negligible impact on macrophage responses when compared with statins. Taken together, our data point toward an immunomodulatory effect of statins on macrophage polarization, which is absent upon bempedoic acid treatment.

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Statin Use and Reduced Risk of Pneumonia in Patients with Melioidosis: A Lung-Specific Statin Association

Coston,

Wright,

Phunpang

et al. 2024

Annals ATS

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Rationale 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) use is associated with a lower risk of incident pneumonia and, less robustly, with nonpulmonary infections. Whether statin use is associated with a lower risk of pneumonia than other clinical presentations of infection with the same pathogen is unknown. Objectives To assess whether preadmission statin use is associated with a lower risk of pneumonia than nonpneumonia presentations among patients hospitalized with Burkholderia pseudomallei infection (melioidosis). Methods We performed a secondary analysis of a prospective multicenter cohort study of patients hospitalized with culture-confirmed B. pseudomallei infection (melioidosis). We used Poisson regression with robust standard errors to test for an association between statin use and pneumonia. We then performed several sensitivity analyses that addressed healthy user effect and indication bias. Results Of 1,372 patients with melioidosis enrolled in the parent cohort, 1,121 were analyzed. Nine hundred eighty (87%) of 1,121 were statin nonusers, and 141 (13%) of 1,121 were statin users. Forty-six (33%) of 141 statin users presented with pneumonia compared with 432 (44%) of 980 statin nonusers. Statin use was associated with a lower risk of pneumonia in unadjusted analysis (relative risk, 0.74; 95% confidence interval, 0.58–0.95; P = 0.02) and, after adjustment for demographic variables, comorbidities, environmental exposures, and symptom duration (relative risk, 0.73; 95% confidence interval, 0.57–0.94; P = 0.02). The results of sensitivity analyses, including active comparator analysis and inverse probability of treatment weighting, were consistent with the primary analysis. Conclusions In hospitalized patients with melioidosis, preadmission statin use was associated with a lower risk of pneumonia than other clinical presentations of melioidosis, suggesting a lung-specific protective effect of statins.

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The Effect of Statins Use on the Risk and Outcome of Acute Bacterial Infections in Adult Patients

Cited by 7 publications

References 36 publications

Statin Use Correlates with Reduced Risk of Pyogenic Liver Abscess: A Population‐Based Case–Control Study

Statin Use Correlates with Reduced Risk of Pyogenic Liver Abscess: A Population‐Based Case–Control Study

Statins and Bempedoic Acid: Different Actions of Cholesterol Inhibitors on Macrophage Activation

Statin Use and Reduced Risk of Pneumonia in Patients with Melioidosis: A Lung-Specific Statin Association

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