Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBiS), Hospitales Universitarios Virgen Macarena y Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
Mayo Clin Proc. 2017 Oct;92(10):1469-1478. doi: 10.1016/j.mayocp.2017.07.008.
To ascertain whether persons treated with statins experience a decreased risk of community-acquired Staphylococcus aureus bacteremia (CA-SAB) as compared with nonusers.
Using population-based medical registries, we conducted a case-control study including all adults with first-time CA-SAB and population controls matched on age, sex, and residence in Northern Denmark from January 1, 2000, through December 31, 2011. Statin users were categorized as current users (new or long-term use), former users, and nonusers. We used conditional logistic regression to compute odds ratios (ORs) for CA-SAB according to statin exposure, overall and stratified by intensity (<20, 20-39, ≥40 mg/d) and duration of use (<365, 365-1094, ≥1095 days).
We identified 2638 patients with first-time CA-SAB and 26,379 matched population controls. Compared with nonusers, current statin users experienced markedly decreased risk of CA-SAB (adjusted OR, 0.73; 95% CI, 0.63-0.84). The adjusted OR was 0.96 (95% CI, 0.60-1.51) for new users, 0.71 (95% CI, 0.62-0.82) for long-term users, and 1.12 (95% CI, 0.94-1.32) for former users as compared with nonusers. The CA-SAB risk decreased with increasing intensity of statin use; thus, compared with nonusers, the adjusted OR was 0.84 (95% CI, 0.68-1.04) for current users with daily dosages of less than 20 mg/d, 0.71 (95% CI, 0.58-0.87) for 20 to 39 mg/d, and 0.63 (95% CI, 0.49-0.81) for 40 mg/d or more. Conversely, we observed no differences in the risk of CA-SAB with successive increases in the duration of statin use.
Statin use was associated with a decreased risk of CA-SAB, particularly in long-term users.
确定与未使用者相比，使用他汀类药物的患者是否会降低社区获得性金黄色葡萄球菌菌血症（CA-SAB）的风险。
我们使用基于人群的医疗登记处进行了一项病例对照研究，该研究纳入了 2000 年 1 月 1 日至 2011 年 12 月 31 日期间，首次发生 CA-SAB 的所有丹麦北部成年人和年龄、性别及居住地相匹配的人群对照。将他汀类药物使用者分为当前使用者（新使用者或长期使用者）、前使用者和未使用者。我们使用条件逻辑回归计算了 CA-SAB 的比值比（OR），总体上和按他汀类药物的使用强度（<20、20-39、≥40 mg/d）和使用时间（<365、365-1094、≥1095 天）进行分层。
我们确定了 2638 例首次发生 CA-SAB 的患者和 26379 例匹配的人群对照。与未使用者相比，当前的他汀类药物使用者发生 CA-SAB 的风险明显降低（校正 OR，0.73；95%CI，0.63-0.84）。与未使用者相比，新使用者的校正 OR 为 0.96（95%CI，0.60-1.51），长期使用者为 0.71（95%CI，0.62-0.82），前使用者为 1.12（95%CI，0.94-1.32）。他汀类药物使用强度越高，CA-SAB 的风险越低；因此，与未使用者相比，当前每天剂量<20mg/d 的使用者校正 OR 为 0.84（95%CI，0.68-1.04），20-39mg/d 的为 0.71（95%CI，0.58-0.87），40mg/d 或更高剂量的为 0.63（95%CI，0.49-0.81）。相反，我们没有观察到他汀类药物使用时间的延长与 CA-SAB 风险的增加之间存在差异。
他汀类药物的使用与 CA-SAB 风险降低有关，尤其是在长期使用者中。
