Table 1.
Summary of statins in COPD retrospective trials and epidemiologic surveys
| Trial | Study design | Patient characteristics | Outcomes |
|---|---|---|---|
| Bando et al29 | Cross-sectional study | All Japanese outpatients >40 years old who regularly visited a participating primary health care facility n=853 | Airflow limitation prevalence 2.25% in statin users vs 10.5% in non-users (P=0.01) Adjusted OR 0.28 (95% CI 0.06–1.28; P=0.101) |
| Lawes et al30 | Population-based cohort | Patients 50–80 years old with hospitalization for COPD in New Zealand n=1,687 patients; 596 in statin group and 1,091 in non-statin group | 242 deaths (40.6%) in statin users vs 429 (39.3%) in non-users Adjusted HR 0.69, (95% CI 0.58–0.84) |
| Sheng et al31 | Population-based cohort | Patients with a diagnosis of COPD in Scotland Primary cardiovascular prevention cohort =1,274 patients; 617 in statin group and 657 in statin-unexposed group. Secondary cardiovascular prevention cohort =443 patients; 292 in the statin group and 151 in the statin-unexposed group |
39% reduction in all-cause mortality in primary prevention statin users HR 0.61 (95% CI 0.43–0.85) 42% reduction in all-cause mortality in secondary prevention statin users HR 0.58 (95% CI 0.43–0.85) |
| Wang et al32 | Retrospective nested case-control | All patients aged >45 years with two or more COPD-related outpatient visits that involved at least two COPD medications 14,316 patients resulting in 1,584 cases of hospitalization for ECOPD and 5,950 matched controls |
Any use of statins is associated with a 30% reduction in exacerbations OR 0.70 (95% CI 0.56–0.88; P<0.05) |
| Ho et al33 | Retrospective, population-based cohort | All patients who had been hospitalized for COPD exacerbations based on ICD-9 codes for COPD or pneumonia with secondary diagnosis of COPD n=4,204; 288 taking statins at enrollment | 1 year mortality with statin use HR 0.33 (95% CI 0.47–0.91; P=0.013) |
| Ingebrigtsen et al34 | Nested case-control | 5,794 patients >40 years old diagnosed with COPD per GOLD criteria and a CRP measurement 530 cases with exacerbations matched to 1,016 controls |
Statin use associated with reduced OR of exacerbation on univariate screen OR 0.68 (95% CI 0.51–0.91; P=0.01); multivariate logistic regression demonstrated OR 0.67 (95% CI 0.48–0.92; P=0.01); in the subgroup with the most severe COPD and no cardiovascular comorbidity, there was no difference; statin use also was associated with decreased CRP OR 0.69 (95% CI 0.56–0.85; P<0.001) and CRP was associated with increased risk of ECOPD HR 1.62 (95% CI 1.35–1.94; P<0.001) |
Abbreviations: ECOPD, exacerbations of COPD; GOLD, Global Initiative for Chronic Obstructive Lung Disease; OR, odds ratio; HR, hazard ratio; CI, confidence interval; ICD-9, International Classification of Diseases, Ninth Revision; CRP, C-reactive protein.