Format

Send to

Choose Destination
Antimicrob Agents Chemother. 2017 Feb 23;61(3). pii: e02228-16. doi: 10.1128/AAC.02228-16. Print 2017 Mar.

Evidence To Support Continuation of Statin Therapy in Patients with Staphylococcus aureus Bacteremia.

Author information

1
Veterans Affairs Medical Center, Infectious Diseases Research Program and Center of Innovation in Long Term Services and Supports, Providence, Rhode Island, USA Aisling_Caffrey@uri.edu KerryLaPlante@uri.edu.
2
University of Rhode Island College of Pharmacy, Kingston, Rhode Island, USA.
3
Brown University School of Public Health, Providence, Rhode Island, USA.
4
Veterans Affairs Medical Center, Infectious Diseases Research Program and Center of Innovation in Long Term Services and Supports, Providence, Rhode Island, USA.
5
University of California San Diego School of Medicine, La Jolla, California, USA.
6
Infectious Disease Division, Memorial Hospital of Rhode Island, Providence, Rhode Island, USA.
7
Warren Alpert Medical School of Brown University, Division of Infectious Diseases, Providence, Rhode Island, USA.

Abstract

In addition to cholesterol-lowering capabilities, statins possess anti-inflammatory and immunomodulatory effects. We sought to quantify the real-world impact of different statin exposure patterns on clinical outcomes in Staphylococcus aureus bacteremia. We conducted a retrospective cohort study among hospitalized patients with positive S. aureus blood cultures receiving appropriate antibiotics within 48 h of culture collection (Veterans Affairs hospitals, 2002 to 2013). Three statin exposure groups were compared to nonusers: pretreated statin users initiating therapy in the 30 days prior to culture and either (i) continuing statin therapy after culture or (ii) not continuing after culture, and (iii) de novo users initiating at culture. Nonusers included patients without statins in the year prior to culture through discharge. Propensity score-matched Cox proportional hazards regression models were developed. We were able to balance significantly different baseline characteristics using propensity score matching for pretreated without continuation (n = 331), pretreated with continuation (n = 141), and de novo (n = 177) statin users compared to nonusers. We observed a significantly lower 30-day mortality rate (hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.25 to 0.84; number needed to treat [NNT], 10) among pretreated and continued statin users, while protective effects were not observed in de novo (HR, 1.04; 95% CI, 0.60 to 1.82; NNT, undefined) or pretreated but not continued (HR, 0.92; 95% CI, 0.64 to 1.32; NNT, 47) users. In our national cohort study among patients with S. aureus bacteremia, continuation of statin therapy among incident statin users was associated with significant beneficial effects on mortality, including a 54% lower 30-day mortality rate.

KEYWORDS:

HMG-CoA reductase inhibitors; Staphylococcus aureus; anti-inflammatory and immunomodulatory effects; bacteremia; mortality; statins

PMID:
28069650
PMCID:
PMC5328562
DOI:
10.1128/AAC.02228-16
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center