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长期他汀类药物治疗对社区获得性肺炎发病率和严重程度的影响:一项真实世界数据分析

Impact of Long-Term Statin Therapy on Incidence and Severity of Community-Acquired Pneumonia: A Real-World Data Analysis.

作者信息

Toledo Diana, Cartanyà-Hueso Àurea, Morros Rosa, Giner-Soriano Maria, Domínguez Àngela, Vilaplana-Carnerero Carles, Grau María

机构信息

Department of Medicine, School of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain.

Biomedical Research Consortium in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.

出版信息

Biomedicines. 2025 Jun 11;13(6):1438. doi: 10.3390/biomedicines13061438.

Abstract

This study aims to evaluate the impact of chronic statin therapy on the incidence of community-acquired pneumonia (CAP) and the rate of intensive care unit (ICU) admissions associated with CAP. : Two population-based dynamic cohorts, consisting of individuals exposed and unexposed to statins, were followed from 2010 to 2019. Participants were older than 60 years, with frail patients excluded. The primary outcomes were the incidence of CAP and ICU admissions due to CAP, serving as a proxy for complicated cases. The exposed cohort included new statin users with at least two pharmacy invoices within 90 days of the recruitment period. Adjusted risk ratios (aRRs) for CAP incidence and CAP-associated ICU admissions were calculated using Poisson regression. : This study analyzed a sample of 639,564 individuals, evenly divided into exposed (319,782) and unexposed (319,782) groups, with a mean age of 71 years (standard deviation of 8 years) and 57% women. New statin users had a higher incidence of CAP [42.1 (95% confidence interval: 41.9-42.2) vs. 36.6 (36.5-36.8) per 1000 person-years] and ICU admissions [11.5 (11.5-11.6) vs. 10.1 (10.0-10.1) per 1000 person-years] compared to non-users. The adjusted analysis indicated that statin treatment reduced CAP risk by 6% [aRR: 0.94 (0.91-0.96)] and ICU admission by 7% [aRR: 0.93 (0.88-0.98)]. : Prior statin therapy was associated with a clinically significant reduction in the incidence of CAP and ICU admissions due to CAP, despite the greater vulnerability of new users at the start of treatment compared to non-users.

摘要

本研究旨在评估长期他汀类药物治疗对社区获得性肺炎(CAP)发病率以及与CAP相关的重症监护病房(ICU)入住率的影响。:2010年至2019年期间,对两个基于人群的动态队列进行了随访,这两个队列分别由使用和未使用他汀类药物的个体组成。参与者年龄超过60岁,排除体弱患者。主要结局是CAP的发病率以及因CAP导致的ICU入住情况,以此作为复杂病例的代表。暴露队列包括在招募期90天内至少有两张药房发票的新他汀类药物使用者。使用泊松回归计算CAP发病率和与CAP相关的ICU入住率的调整风险比(aRRs)。:本研究分析了639,564名个体的样本,平均分为暴露组(319,782人)和未暴露组(319,782人),平均年龄为71岁(标准差8岁),女性占57%。与未使用者相比,新他汀类药物使用者的CAP发病率更高[每1000人年42.1(95%置信区间:41.9 - 42.2)对36.6(36.5 - 36.8)],ICU入住率也更高[每1000人年11.5(11.5 - 11.6)对10.1(10.0 - 10.1)]。调整分析表明,他汀类药物治疗使CAP风险降低了6%[aRR:0.94(0.91 - 0.96)],ICU入住率降低了7%[aRR:0.93(0.88 - 0.98)]。:尽管新使用者在治疗开始时比未使用者更易患病,但先前的他汀类药物治疗与CAP发病率以及因CAP导致的ICU入住率的临床显著降低相关。

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