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Impact of statins and angiotensin-converting enzyme inhibitors on mortality of subjects hospitalised with pneumonia

¹ VERDICT, ² Divisions of General Internal Medicine, ⁴ Pulmonary and Critical Care Medicine, and ⁴ Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

CORRESPONDENCE: E. M. Mortensen, VERDICT, ALMD/UTHSCSA, Ambulatory Care (11C6), 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA. Fax: 1 2105674423. E-mail: mortensene{at}uthscsa.edu

Keywords: Angiotensin-converting enzyme inhibitor, 3-hydroxl-3-methyl-glutaryl-CoA reductase inhibitor, mortality, pneumonia

Received: December 11, 2006
Accepted September 23, 2007

Recent studies suggest that statins and angiotensin-converting enzyme (ACE) inhibitors may have beneficial effects for some types of infections. The present study aimed to examine the association of outpatient use of these medications on 30-day mortality for subjects aged >65 yrs and hospitalised with community-acquired pneumonia.

A retrospective national cohort study was conducted using the Department of Veterans Affairs administrative data including subjects aged 65 yrs hospitalised with community-acquired pneumonia, and having 1 yr of prior Veterans Affairs outpatient care.

In total, 8,652 subjects were identified with a mean age of 75 yrs, 98.6% were male, and 9.9% of subjects died within 30 days of presentation. In this cohort, 18.1% of subjects were using statins and 33.9% were using ACE inhibitors. After adjusting for potential confounders, current statin use (odds ratio (OR) 0.54, 95% confidence interval (CI) 0.42–0.70) and ACE inhibitor use (OR 0.80, 95% CI 0.68–0.89) were significantly associated with decreased 30-day mortality.

Use of statins and angiotensin-converting enzyme inhibitors prior to admission is associated with decreased mortality in subjects hospitalised with community-acquired pneumonia. Randomised controlled trials are needed to examine whether the use of these medications in patients hospitalised with community-acquired pneumonia may be beneficial.

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