Systematic review and meta-analysis on the association between outpatient statins use and infectious disease-related mortality

PLoS One. 2012;7(12):e51548. doi: 10.1371/journal.pone.0051548. Epub 2012 Dec 17.

Abstract

Background: To update and refine systematic literature review on the association between outpatient statins use and mortality in patients with infectious disease.

Materials and methods: We searched articles published before September 31, 2012, on the association between statins and infectious disease-related mortality through electronic databases. Eligible articles were analyzed in Review Manager 5.1. We conducted stratification analysis by study design, infection types, clinical outcomes and study locations.

Results: The pooled odds ratio (OR) for death (statins use vs. no use) across the 41 included studies was 0.71 (95% confidence interval: 0.64, 0.78). The corresponding pooled ORs were 0.58 (0.38, 0.90), 0.66 (0.57, 0.75), 0.71 (0.57, 0.89) and 0.83 (0.67, 1.04) for the case-control study, retrospective cohort studies, prospective cohort studies and RCTs; 0.40 (0.20, 0.78), 0.61 (0.41, 0.90), 0.69 (0.62, 0.78) and 0.86 (0.68, 1.09) for bacteremia, sepsis, pneumonia and other infections; 0.62 (0.534, 0.72), 0.68 (0.53, 0.89), 0.71 (0.61, 0.83) and 0.86 (0.70, 1.07) for 30-day, 90-day, in-hospital and long-term (>1 year) mortality, respectively.

Conclusions: Outpatient statins use is associated with a lower risk of death in patients with infectious disease in observational studies, but in a less extent in clinical trials. This association also varies considerably by infection types and clinical outcomes.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Case-Control Studies
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Infections / drug therapy
  • Infections / mortality*
  • Review Literature as Topic
  • Survival Rate

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors

Grant support

This project was supported by the Natural Science Foundation of China (NSFC) [grant No. 81172735] (http://159.226.244.22/portal/Proj_List.asp). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.