Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
Pulm Pharmacol Ther. 2013 Apr;26(2):212-7. doi: 10.1016/j.pupt.2012.10.008. Epub 2012 Nov 7.
Studies suggest that statins decrease mortality in COPD patients but it is unknown which patients might benefit most.
We investigated whether statins were associated with reduced mortality in COPD patients and whether effects differed according to baseline high-sensitivity C-reactive protein (hsCRP) concentration, a marker of systemic inflammation.
This nested case-control study was part of the Rotterdam Study, a prospective population-based cohort study among 7983 subjects ≥ 55 years. Using automated pharmacy records, we evaluated statin use of 363 cases (COPD patients who died during follow-up of 17 years) with 2345 age and sex matched controls (COPD patients who survived the follow-up period of the index case).
Compared to never use, long-term statin use (>2 years) was associated with a 39% decreased risk of death in COPD patients. Stratified according to the level of systemic inflammation, long-term statin use was associated with a 78% reduced mortality if hsCRP level > 3 mg/L, versus a non significant 21% reduced mortality if hsCRP level ≤ 3 mg/L.
Statin use is associated with a beneficial effect on all-cause mortality in COPD, depending on the baseline level of systemic inflammation.
研究表明他汀类药物可降低 COPD 患者的死亡率，但尚不清楚哪些患者可能受益最大。
我们研究了他汀类药物是否与 COPD 患者的死亡率降低相关，以及其效果是否因基线高敏 C 反应蛋白（hsCRP）浓度的不同而有所不同，hsCRP 是全身炎症的标志物。
这项巢式病例对照研究是鹿特丹研究的一部分，该研究是一项针对 7983 名年龄≥55 岁的前瞻性人群队列研究。我们使用自动化药房记录，评估了 363 例（在 17 年的随访期间死亡的 COPD 患者）和 2345 例年龄和性别匹配的对照者（在指数病例的随访期间存活的 COPD 患者）的他汀类药物使用情况。
与从未使用相比，长期使用他汀类药物（>2 年）与 COPD 患者的死亡风险降低 39%相关。根据全身炎症水平分层，hsCRP 水平>3mg/L 时，长期使用他汀类药物与死亡率降低 78%相关，而 hsCRP 水平≤3mg/L 时，死亡率降低不显著（21%）。
他汀类药物的使用与 COPD 患者的全因死亡率降低相关，这取决于基线全身炎症水平。
