Prior statin therapy is associated with a decreased rate of severe sepsis

• Published in: Circulation (New York, N.Y.) Vol. 110; no. 7; pp. 880 - 885
• Main Authors: Almog, Yaniv, Shefer, Alexander, Novack, Victor, Maimon, Nimrod, Barski, Leonid, Eizinger, Miruna, Friger, Michael, Zeller, Lior, Danon, Abraham
• Format: Journal Article
• Language: English
• Published: United States 17-08-2004
• Subjects: Aged; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Bacterial Infections - complications; Cardiovascular Diseases - epidemiology; Cellulitis - complications; Cohort Studies; Comorbidity; Diabetes Mellitus - epidemiology; Endotoxins - blood; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hyperlipidemias - epidemiology; Immunologic Factors - therapeutic use; Intensive Care Units - utilization; Israel - epidemiology; Lipids - blood; Male; Middle Aged; Models, Biological; Pneumonia, Bacterial - complications; Prospective Studies; Pulmonary Disease, Chronic Obstructive - epidemiology; Risk; Sepsis - epidemiology; Sepsis - prevention & control; Severity of Illness Index; Single-Blind Method; Urinary Tract Infections - complications; Israel
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.0000138932.17956.F1

Statins have anti-inflammatory properties that are independent of their lipid-lowering abilities. We hypothesized that statin therapy before the onset of an acute bacterial infection may have a protective effect against severe sepsis. The aim of this study was to determine whether patients treated with statins develop severe sepsis less frequently.
In this prospective observational cohort study, consecutive patients admitted with presumed or documented acute bacterial infection were enrolled. The primary outcomes were the rate of severe sepsis and intensive care unit (ICU) admission. Of the 361 patients enrolled, 82 (22.7%) were treated with statins before their admission. Both groups had a similar severity of illness on admission. Severe sepsis developed in 19% of patients in the no-statin group and in only 2.4% of the statin group (P<0.001). Statin treatment was associated with a relative risk of developing severe sepsis of 0.13 (95% CI, 0.03 to 0.52) and an absolute risk reduction of 16.6%. The overall ICU admission rate was 10.2% (37/361): 12.2% of the no-statin group required ICU admission, whereas in the statin group only 3.7% were admitted to the ICU (P=0.025), reflecting a relative risk of ICU admission of 0.30 (95% CI, 0.1 to 0.95).
Prior therapy with statins may be associated with a reduced rate of severe sepsis and ICU admission. If supported by prospective controlled trials, statins may have a role in the primary prevention of sepsis.