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Meta-Analysis
. 2015 Jul 9;10(7):e0130071.
doi: 10.1371/journal.pone.0130071. eCollection 2015.

The Effects of Statins on Infections after Stroke or Transient Ischemic Attack: A Meta-Analysis

Shao-Peng Lin  1 , You-Ming Long  2 , Xiao-Hui Chen  1
Affiliations
Free PMC article
Meta-Analysis

The Effects of Statins on Infections after Stroke or Transient Ischemic Attack: A Meta-Analysis

Shao-Peng Lin et al. PLoS One. .
Free PMC article

Abstract

Background: Previous studies have reported that statins can prevent infections, and these findings were ascribed to the anti-inflammatory and immunomodulatory properties of statins. However, the effects of statins on the risk of infection after stroke or transient ischemic attack (TIA) remain controversial. The aim of this study was to evaluate the relationship between statins and the risk of infection after stroke or TIA by means of a meta-analysis.

Methodology and findings: Studies were found by searching major electronic databases using key terms and restricting the results to studies published in English language and human studies. Pooled odds ratio (OR) for the association between infection and statins were analyzed using Stata software. A total of five studies that included 8,791 stroke or TIA patients (3,269 patients in the statin use group and 5,522 in the placebo group) were eligible and abstracted. Pooled analysis demonstrated that statins did not significantly affect the incidence of infection after stroke or TIA compared with a placebo (OR 0.819, 95% CI 0.582-1.151, I2 = 64.2%, p= 0.025). Sensitivity analyses showed that the removal of any single study did not significantly affect the pooled OR. Cumulative meta-analysis showed that the incidence of infection did not vary by publication year. No statistical evidence of publication bias was found among the studies selected, based on the results of Egger's (p = 1.000) and Begg's (p = 0.762) tests.

Conclusions: This meta-analysis does not support the hypothesis that statins reduce the risk of infections in stroke or TIA patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow chart of study identification and inclusion.
Fig 2
Fig 2. The association between statins and infection after stroke or TIA.
Fig 3
Fig 3. Sensitivity analyses for the five included studies (Each small circle indicates mean differences.
The intervals between the two short lines around each circle indicate the 95% CI of each study).
Fig 4
Fig 4. Cumulative meta-analysis of the effect of statins on infection after stroke or TIA(Note: weights are from random effects analysis).
Fig 5
Fig 5. Begg’s funnel plot for the analysis of publication bias in studies on the incidence of infection, including all five studies comparing patients exposed and unexposed to statins.
See this image and copyright information in PMC

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Grants and funding

This study was supported by the Key Medical Disciplines and Specialties Program of Guangzhou and the Science and Technology plan project of Guangdong Province (2011B061300004).