COPD Mortality Improves With Statins
While data are conflicting, statin use in COPD may help reduce pulmonary-related and all-cause mortality.
Statin use may decrease pulmonary-related and all-cause mortality in patients with chronic obstructive pulmonary disease (COPD), according to a study published in CHEST.
Patients with COPD are twice as likely as the general population to have cardiovascular disease (CVD). The increased CVD-related mortality in patients with COPD has such a significant impact that all-cause mortality is now used as the primary outcome measure in COPD.
“COPD patients are at increased risk of CVD-related mortality, which may increase as the severity of their COPD worsens; therefore, statins are often indicated for use in patients with COPD,” Larry Lynd, PhD, from the University of British Columbia in Vancouver, Canada, said in an interview with Cardiology Advisor.
Statins have been shown to lower all-cause mortality in patients with CVD risk factors, but whether statins improve outcomes in COPD patients is unclear. Data are conflicting and limited regarding the effect of statins on the risk of COPD exacerbations, pulmonary-related mortality, and all-cause mortality.
Dr Lynd and colleagues from the University of British Columbia evaluated the impact of statin use on pulmonary-related and all-cause mortality in patients with COPD using data from an administrative health utilization database that includes data on all prescriptions filled by every resident of British Columbia.
Of 39,678 patients with COPD, 7775 (19.6%) received at least 1 statin within 1 year after COPD diagnosis. A total of 1446 deaths occurred in patients with COPD within 1 year of statin exposure.
Statin use was associated with a 20% lower risk for all-cause mortality (hazard ratio [HR], 0.79; 95% CI, 0.67-0.92; P =.0016) and a 45% lower risk for pulmonary-related mortality (HR, 0.55; 95% CI, 0.32-0.93; P =.0245) within 1 year of statin exposure.
“This population-based study suggests that statins may reduce both all-cause and pulmonary-related mortality, potentially related to their anti-inflammatory effects,” Dr Lynd told Cardiology Advisor.
“The pleotropic effects of statins may extend beyond reductions in all-cause mortality,” he added. “For instance, there is evidence suggesting that statins may reduce the risk of lung cancer as well. Thus, the overall benefits conferred by statin use in COPD may be even greater than currently estimated based on this evidence.”
However, whether statins retain their protective effects across all subgroups of patients with COPD is unknown.
“This observational study did not include smoking status or the smoking history of COPD patients. Thus, it remains unclear what differential effects statins might have in smokers vs non-smokers,” Dr Lynd noted.
Dr Lynd has provided consultation services to Teva, Pfizer, and Novartis.
Raymakers AJ, Sadatsafavi M, Sin DD, De Vera MA, Lynd LD. The impact of statin use on all-cause mortality in patients with COPD: a population based cohort study. [published online February 12, 2017] Chest. doi:10.1016/j.chest.2017.02.002