Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
J Cardiothorac Vasc Anesth. 2021 Dec;35(12):3612-3619. doi: 10.1053/j.jvca.2021.02.019. Epub 2021 Feb 12.
To investigate whether prior statin therapy is associated with an improvement in mortality among patients who undergo extracorporeal membrane oxygenation (ECMO) therapy.
Retrospective, population-based, cohort study.
Health records were obtained from the National Health Insurance Service database in South Korea.
All adult patients (≥18 y) who underwent ECMO therapy in the intensive care unit between 2005 and 2018 were enrolled.
Statin users were defined as patients who were prescribed continuous oral statins ≥90 days before ECMO.
The primary endpoint of this study was 90-day mortality. A total of 21,129 adult patients from 128 hospitals were included (4,737 [22.4%] statin users and 16,392 [77.6%] nonusers). After propensity score matching, 9,474 ECMO patients (4,737 in each group) were included in the final analysis. In the propensity-score-matched cohort, statin users exhibited lower 90-day mortality than did nonusers (58.6% [2,774/4,737] in statin users v 65.6% [3,106/4,737] in nonusers). In addition, on Cox regression, 90-day mortality in statin users was 14% less than that in nonusers (hazard ratio 0.86, 95% confidence interval 0.81-0.90; p < 0.001).
Among patients who underwent ECMO in South Korea, prior statin therapy was found to be associated with lower 90-day mortality rates after ECMO therapy. However, because this study had a retrospective design, future prospective trials are needed to confirm the findings.
研究体外膜肺氧合（ECMO）治疗患者中，预先使用他汀类药物治疗是否与死亡率的改善相关。
回顾性、基于人群的队列研究。
研究数据来自韩国国家健康保险服务数据库中的健康记录。
纳入 2005 年至 2018 年间在重症监护病房接受 ECMO 治疗的所有成年患者（≥18 岁）。
他汀类药物使用者定义为在 ECMO 前≥90 天连续口服他汀类药物的患者。
本研究的主要终点为 90 天死亡率。共纳入来自 128 家医院的 21129 名成年患者（4737 名[22.4%]他汀类药物使用者和 16392 名[77.6%]非使用者）。经倾向评分匹配后，最终分析纳入 9474 名 ECMO 患者（每组 4737 名）。在倾向评分匹配队列中，他汀类药物使用者的 90 天死亡率低于非使用者（他汀类药物使用者为 58.6%[2774/4737]，非使用者为 65.6%[106/4737]）。此外，在 Cox 回归中，他汀类药物使用者的 90 天死亡率比非使用者低 14%（风险比 0.86，95%置信区间 0.81-0.90；p<0.001）。
在韩国接受 ECMO 的患者中，预先使用他汀类药物治疗与 ECMO 治疗后较低的 90 天死亡率相关。然而，由于本研究为回顾性设计，需要进一步的前瞻性试验来证实这些发现。
