2008, Number 3
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An Med Asoc Med Hosp ABC 2008; 53 (3)
Statins in the prevention, severity, and mortality associated to sepsis
Espinosa AL, García GJ, Rosales CM, Mendoza AR, Rojas ZE, Moreno SF
Language: Spanish
References: 16
Page: 113-119
PDF size: 162.81 Kb.
ABSTRACT
Objective: To demonstrate the role of statins as antiinflammatory agents and their function in the prevention severity and mortality associated to sepsis, as well as to identify the factors of risk to develop severe sepsis.
Material and methods: A retrospective, observational, comparative, transverse study of cases and controls was performed. Medical records from the ABC Medical Center database were reviewed of patients that were admitted from January, 2003 to August, 2005, with diagnoses of pneumonia, infection of urinary tract and endocarditis. The end point was the development of severe sepsis and mortality from the patient admission until he was discharged.
Results: 44% of the patients without statins developed severe sepsis compared with 16% of patients with statins. Mortality of the patients of the group of statins was of 8%, compared with 16% in patients not receiving statins before admission.
Conclusions: We observed a diminished incidence of severe sepsis and related death in patients receiving statins previous to systemic infection. This could be an additional benefit of statins use related to their anti-inflammatory properties. A prospective study should be performed in order to confirm our data.
REFERENCES
Maron DJ et al. Current perspectives on statins. Circulation 2000; 101: 207-213.
Weitz-Schmidt G et al. Statins selectively inhibit leukocyte function antigen -1 by binding to a novel regulatory integrin site. Nat Med 2001; 7: 687-692.
Bellosta S et al. Non lipid -related effects of statins. Ann Med 2000; 32: 164-176.
Kwak B et al. Statins (HMG-CoA reductase inhibitors) as a novel type of immunosupresor. Nature Med 2000; 6: 1399-1402.
Laufs U et al. Upregulation of endothelial nitric oxide synthase by HMG CoA reductase inhibitors. Circulation 1998; 97: 1129-1135.
Lefer D et al. Statins as potent anti-inflammatory drugs. Circulation 2002; 106: 2041-2042.
Freeman DJ et al. Pravastatin and the development of diabetes mellitus. Evidence of a protective treatment effect in the West of Scotland Coronary Prevention Study. Circulation 2001; 103: 357.
Tonolo G et al. Additive effects of simvastatin beyond its effects on LDL cholesterol in hypertensive type 2 diabetic patients. Eur J Clin Invest 2000; 30: 980.
Poynter JN et al. HMG CoA reductase inhibitors and the risk of colorectal cancer. Proc Am Soc Clin Oncol 2004; 23: 1a.
Tonelli M et al. Effect of pravastatin on loss of renal function in people with moderate chronic renal insufficiency and cardiovascular disease. J Am Soc Nephrol 2003; 14: 1605.
Ridker P et al. Long term effect of pravastatin on plasma concentration of C-reactive protein. Circulation 1999; 100: 230-235.
Almog Y et al. Prior statin therapy is associated UIT a decreased rate of severe sepsis. Circulation 2004; 110: 880-888.
Bartlett JG, Breiman RF et al. Practice guidelines for the management of community acquired pneumonia in adults. Clin Infect Dis 2000; 31: 347-382.
Rubenstein et al. Managing complicated urinary tract infections: The urologic view. J Am Soc Nephrol 2003; 17: 333-351.
Wilson et al. Antibiotic treatment of adults with infective endocarditis due to streptococci, enterococci, sthaphylococci and HACEK microorganisms. JAMA 1995; 274: 1706-1713.
Liappis AP et al. The Effect of statins on mortality in patients with bacteremia. Clin Infect Dis 2001; 33: 1352-1357.