In the Journals

Statins may protect cirrhotic patients from infection

Veterans with cirrhosis who used statins were at reduced risk for developing severe infection compared with nonusers, according to recent results.

In a retrospective cohort study, researchers evaluated data from 19,379 veterans with cirrhosis without decompensation, collected from the US Veterans Health Administration’s Austin Information Technology Center database between 2001 and 2009. In an additional, propensity-matched analysis, new statin users were matched equally against nonusers (n=1,760) and those receiving other cholesterol-lowering therapies (n=503). Incidence of infection and hospitalization was observed during a median 1,194 days of follow-up.

Approximately 13% of participants were statin users. Serious infection occurred in 12.4% of patients, including 946 cases of pneumonia, 866 skin infections, 171 bacteremia infections, 143 of septicemia, 131 cases of Clostridium difficile, 73 cases of spontaneous bacterial peritonitis/peritonitis and 32 urinary tract infections (UTI). Time to infection ranged from 394 days (kidney infections/UTI) to 1,057 days (systemic inflammatory response syndrome). Liver transplantation was performed in 0.5% of cases, and 0.1% of participants died during follow-up.

Use of statins (adjusted HR=0.42; 95% CI, 0.36-0.48) and other cholesterol medications (aHR=0.44; 95% CI, 0.33-0.61) was associated with reduced risk for infection, after adjusting for age, race, year of cohort entry, hepatitis C status, cirrhosis etiology, comorbidities and use of concurrent medications. In the propensity-matched analysis, risk for infection or death was lower among statin users compared with nonusers (aHR=0.67; 95% CI, 0.47-0.95), and an observed risk reduction for statin users compared with those on other cholesterol-lowering therapies trended toward significance (aHR=0.77; 95% CI, 0.31-1.94).

“One of statins’ many potential benefits, aside from cholesterol lowering, is the potential to reduce infections in patients with cirrhosis,” researcher Christine Motzkus-Feagans, MPH, department of quantitative health sciences at University of Massachusetts Medical School, told Healio.com. “While the evidence is still unclear, the data are suggestive of a link to reduced infections in patients taking statins. This is important because infections, especially those related to hospitalizations that were studied here, are one of the highest causes of death in cirrhosis.”

Disclosure: Researcher K. L. Lapane has served as a consultant for Ortho-McNeil Janssen Scientific Affairs.

Veterans with cirrhosis who used statins were at reduced risk for developing severe infection compared with nonusers, according to recent results.

In a retrospective cohort study, researchers evaluated data from 19,379 veterans with cirrhosis without decompensation, collected from the US Veterans Health Administration’s Austin Information Technology Center database between 2001 and 2009. In an additional, propensity-matched analysis, new statin users were matched equally against nonusers (n=1,760) and those receiving other cholesterol-lowering therapies (n=503). Incidence of infection and hospitalization was observed during a median 1,194 days of follow-up.

Approximately 13% of participants were statin users. Serious infection occurred in 12.4% of patients, including 946 cases of pneumonia, 866 skin infections, 171 bacteremia infections, 143 of septicemia, 131 cases of Clostridium difficile, 73 cases of spontaneous bacterial peritonitis/peritonitis and 32 urinary tract infections (UTI). Time to infection ranged from 394 days (kidney infections/UTI) to 1,057 days (systemic inflammatory response syndrome). Liver transplantation was performed in 0.5% of cases, and 0.1% of participants died during follow-up.

Use of statins (adjusted HR=0.42; 95% CI, 0.36-0.48) and other cholesterol medications (aHR=0.44; 95% CI, 0.33-0.61) was associated with reduced risk for infection, after adjusting for age, race, year of cohort entry, hepatitis C status, cirrhosis etiology, comorbidities and use of concurrent medications. In the propensity-matched analysis, risk for infection or death was lower among statin users compared with nonusers (aHR=0.67; 95% CI, 0.47-0.95), and an observed risk reduction for statin users compared with those on other cholesterol-lowering therapies trended toward significance (aHR=0.77; 95% CI, 0.31-1.94).

“One of statins’ many potential benefits, aside from cholesterol lowering, is the potential to reduce infections in patients with cirrhosis,” researcher Christine Motzkus-Feagans, MPH, department of quantitative health sciences at University of Massachusetts Medical School, told Healio.com. “While the evidence is still unclear, the data are suggestive of a link to reduced infections in patients taking statins. This is important because infections, especially those related to hospitalizations that were studied here, are one of the highest causes of death in cirrhosis.”

Disclosure: Researcher K. L. Lapane has served as a consultant for Ortho-McNeil Janssen Scientific Affairs.