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Chronic obstructive pulmonary disease
Statins and morbidity and mortality in COPD in the COMIC study: a prospective COPD cohort study
  1. Emanuel Citgez1,3,
  2. Job van der Palen2,3,
  3. Kirsten Koehorst-ter Huurne1,
  4. Kris Movig4,
  5. Paul van der Valk1 and
  6. Marjolein Brusse-Keizer2
  1. 1Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
  2. 2Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands
  3. 3Department of Research Methodology, Measurement, and Data analysis, University of Twente, Enschede, The Netherlands
  4. 4Department of Clinical Pharmacy, Medisch Spectrum Twente, Enschede, The Netherlands
  1. Correspondence to Dr Emanuel Citgez; e.citgez{at}mst.nl

Abstract

Background Both chronic inflammation and cardiovascular comorbidity play an important role in the morbidity and mortality of patients with chronic obstructive pulmonary disease (COPD). Statins could be a potential adjunct therapy. The additional effects of statins in COPD are, however, still under discussion. The aim of this study is to further investigate the association of statin use with clinical outcomes in a well-described COPD cohort.

Methods 795 patients of the Cohort of Mortality and Inflammation in COPD (COMIC) study were divided into statin users or not. Statin use was defined as having a statin for at least 90 consecutive days after inclusion. Outcome parameters were 3-year survival, based on all-cause mortality, time until first hospitalisation for an acute exacerbation of COPD (AECOPD) and time until first community-acquired pneumonia (CAP). A sensitivity analysis was performed without patients who started a statin 3 months or more after inclusion to exclude immortal time bias.

Results Statin use resulted in a better overall survival (corrected HR 0.70 (95% CI 0.51 to 0.96) in multivariate analysis), but in the sensitivity analysis this association disappeared. Statin use was not associated with time until first hospitalisation for an AECOPD (cHR 0.95, 95% CI 0.74 to 1.22) or time until first CAP (cHR 1.1, 95% CI 0.83 to 1.47).

Conclusions In the COMIC study, statin use is not associated with a reduced risk of all-cause mortality, time until first hospitalisation for an AECOPD or time until first CAP in patients with COPD.

  • COPD Exacerbations
  • COPD Pharmacology
  • Pneumonia

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjresp-2016-000142

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