Continuation of statin therapy in patients with presumed infection: A randomized controlled trial

Peter S. Kruger, Meg L. Harward, Mark A. Jones, Christopher J. Joyce, Karam M. Kostner, Michael S. Roberts, Bala Venkatesh

Research output: Contribution to journalArticleResearchpeer-review

88 Citations (Scopus)

Abstract

Rationale: In patients on prior statin therapywhoare hospitalized for acute infections, current literature is unclear on whether statins should be continued during their hospitalization. Objectives: To test the hypothesis that continuation of therapy with statins influences the inflammatory response to infection and that cessation may cause an inflammatory rebound. Methods: Prospective randomized double-blind placebo-controlled trial of atorvastatin (20 mg) or matched placebo in 150 patients on preexisting statin therapy requiring hospitalization for infection. Measurements and Main Results: The primary end point was progression of sepsis during hospitalization. At baseline, the rate of severe sepsis was 32% in both groups. Compared with baseline, the odds ratio for severe sepsis declined in both groups: 0.43 placebo and 0.5 statins (Day 3) versus 0.14 placebo and 0.12 statins (Day 14). The rate of decline of severe sepsis was similar between the groups (odds ratio 1.17 [0.56-2.47], P = 0.7 Day 3; 0.85 [0.21-3.34], P = 0.8 Day 14). IL-6 and C-reactive protein declined in both groups with no statistically significant difference (P = 0.7 and P = 0.2, respectively). An increase in cholesterol occurred in the placebo group (P < 0.0001). Most patients were not critically ill. Hospital mortality was 6.6%, with no difference between the groups (6 [8%] of 75 statin group; 4 [5.3%] of 75 placebo group; P = 0.75). Conclusions: This study does not support a beneficial role of continuing preexisting statin therapy on sepsis and inflammatory parameters. Cessation of established statin therapy was not associated with an inflammatory rebound. Clinical trial registered at the Australian New Zealand Clinical Trials Registry (ACTRN 12605000756628).

Original languageEnglish
Pages (from-to)774-781
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume183
Issue number6
DOIs
Publication statusPublished - 15 Mar 2011
Externally publishedYes

Fingerprint

Dive into the research topics of 'Continuation of statin therapy in patients with presumed infection: A randomized controlled trial'. Together they form a unique fingerprint.

Cite this