The effect of statins on mortality in septic patients: a meta-analysis of randomized controlled trials

PLoS One. 2013 Dec 31;8(12):e82775. doi: 10.1371/journal.pone.0082775. eCollection 2013.

Abstract

Objective: Statins are among the most prescribed drugs worldwide and their recently discovered anti-inflammatory effect seems to have an important role in inhibiting proinflammatory cytokine production, chemokines expression and counteracting the harmful effects of sepsis on the coagulation system. We decided to perform a meta-analysis of all randomized controlled trials ever published on statin therapy in septic patients to evaluate their effect on survival and length of hospital stay.

Data sources and study selection: Articles were assessed by four trained investigators, with divergences resolved by consensus. BioMedCentral, PubMed, Embase and the Cochrane Central Register of clinical trials were searched for pertinent studies. Inclusion criteria were random allocation to treatment and comparison of statins versus any comparator in septic patients.

Data extraction and synthesis: Data from 650 patients in 5 randomized controlled studies were analyzed. No difference in mortality between patients receiving statins versus control (44/322 [14%] in the statins group vs 50/328 [15%] in the control arm, RR = 0.90 [95% CI 0.65 to 1.26], p = 0.6) was observed. No differences in hospital stay (p = 0.7) were found.

Conclusions: Published data show that statin therapy has no effect on mortality in the overall population of adult septic patients. Scientific evidence on statins role in septic patients is still limited and larger randomized trials should be performed on this topic.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Blood Coagulation / drug effects
  • Cytokines / biosynthesis
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Inflammation Mediators / metabolism
  • Randomized Controlled Trials as Topic
  • Sepsis / drug therapy*
  • Sepsis / mortality*
  • Sepsis / physiopathology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Cytokines
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Inflammation Mediators

Grant support

The authors have no support or funding to report.