Established Statin Use Reduces Mortality From Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis

E. Fitzgerald, L. Duquette, Matthew Williams
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引用次数: 2

Abstract

Background: Statin therapy (ST) has been associated with improved outcomes from sepsis. Our objective was to systematically review the association between established ST and outcomes of patients with community-acquired pneumonia (CAP) that is severe enough to require hospitalisation. Methods: Two meta-analyses were conducted following a search of articles published before 31st January 2013. After exclusions, seven studies were included to assess the effects of statins on 30-day mortality from CAP, and eight studies were included to assess the effects of statins on the development of CAP. Endpoints were a reduction in the risk of 30-day mortality or risk of developing CAP. Results: A reduction in the risk of 30-day mortality from CAP was identified in patients established on ST (pooled odds ratio [OR]: 0.70, 95% confidence interval [CI]: 0.65-0.76; adjusted OR: 0.58, 95% CI: 0.47-0.69). The pooled OR for risk of developing CAP in patients with and without established ST was 1.01 (95% CI: 0.98-1.04). Conclusion: There appears to be weak evidence to suggest a potential benefit of established ST. It is associated with a reduced risk of 30-day mortality in patients subsequently hospitalised with CAP. Further evidence is required, but ST could be considered as a means of reducing the risk of mortality from pneumonia.
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既定的他汀类药物使用降低社区获得性肺炎的死亡率:一项系统回顾和荟萃分析
背景:他汀类药物治疗(ST)与脓毒症的预后改善有关。我们的目的是系统地回顾已确诊的ST与严重到需要住院治疗的社区获得性肺炎(CAP)患者预后之间的关系。方法:检索2013年1月31日前发表的文章,进行两项荟萃分析。排除后,纳入了7项研究来评估他汀类药物对CAP 30天死亡率的影响,并纳入了8项研究来评估他汀类药物对CAP发展的影响。终点是30天死亡率或发展为CAP的风险降低。结果:ST患者发现CAP 30天死亡率降低(合并优势比[or]: 0.70, 95%置信区间[CI]: 0.65-0.76;调整OR: 0.58, 95% CI: 0.47-0.69)。合并ST和未合并ST的患者发生CAP风险的综合OR为1.01 (95% CI: 0.98-1.04)。结论:似乎没有足够的证据表明ST的潜在益处,它与随后因CAP住院的患者的30天死亡率风险降低有关。需要进一步的证据,但ST可以被认为是降低肺炎死亡率风险的一种手段。
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