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. 2009 Jun 3;10(1):45.
doi: 10.1186/1465-9921-10-45.

Impact of statins and ACE inhibitors on mortality after COPD exacerbations

Eric M Mortensen  1 , Laurel A Copeland, Mary Jo V Pugh, Marcos I Restrepo, Rosa Malo de Molina, Brandy Nakashima, Antonio Anzueto
Affiliations

Impact of statins and ACE inhibitors on mortality after COPD exacerbations

Eric M Mortensen et al. Respir Res. .

Abstract

Background: The purpose of our study was to examine the association of prior outpatient use of statins and angiotensin converting enzyme (ACE) inhibitors on mortality for subjects >or= 65 years of age hospitalized with acute COPD exacerbations.

Methods: We conducted a retrospective national cohort study using Veterans Affairs administrative data including subjects >or=65 years of age hospitalized with a COPD exacerbation. Our primary analysis was a multilevel model with the dependent variable of 90-day mortality and hospital as a random effect, controlling for preexisting comorbid conditions, demographics, and other medications prescribed.

Results: We identified 11,212 subjects with a mean age of 74.0 years, 98% were male, and 12.4% of subjects died within 90-days of hospital presentation. In this cohort, 20.3% of subjects were using statins, 32.0% were using ACE inhibitors or angiotensin II receptor blockers (ARB). After adjusting for potential confounders, current statin use (odds ratio 0.51, 95% confidence interval 0.40-0.64) and ACE inhibitor/ARB use (0.55, 0.46-0.66) were significantly associated with decreased 90-day mortality.

Conclusion: Use of statins and ACE inhibitors prior to admission is associated with decreased mortality in subjects hospitalized with a COPD exacerbation. Randomized controlled trials are needed to examine whether the use of these medications are protective for those patients with COPD exacerbations.

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Figures

Figure 1
Figure 1
Proportion of surviving patients hospitalized with COPD exacerbation by use of statin versus non-use (p < 0.0001).
Figure 2
Figure 2
Proportion of surviving patients hospitalized with COPD exacerbation by use of ACE inhibitor versus non-use (p < 0.001).
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