54% Better survival in hospitalized flu patients on statins

Better survival in hospitalized flu patients on statins
November 4, 2009 | Daniel M Keller
Adapted from Medscape Medical News—a professional news service of WebMD


Philadelphia, PA - Patients who were hospitalized for seasonal influenza while already taking statin drugs experienced a 54% lower risk of death in the hospital or within 30 days of discharge compared with patients who had not been using statins [1]. The findings, presented at the Infectious Diseases Society of America 2009 Meeting, come from a retrospective chart review to investigate the effect of statin use on mortality among hospitalized patients with laboratory-confirmed seasonal influenza.

The Emerging Infections Program (EIP) Hospitalized Influenza Surveillance System covers 59 counties in 10 states and includes 7% of the US population. During the 2007-2008 year, 2800 patients met the criteria for inclusion in the study, namely being >18 years old, residing in the EIP surveillance area, and being hospitalized with a positive influenza test. Patients with unknown statin use or who were on mechanical ventilation, which would preclude oral statin therapy, were excluded.

Using a multivariable logistic regression modeling strategy, researchers, led by epidemiologist Meredith Vandermeer (Oregon Public Health Division EIP, Portland), found that statin use during hospitalization was associated with a 54% lower risk of death during the observed period (odds ratio 0.46; 95% CI 0.26-0.81). Whites were at a greater risk of death (OR 3.98; 95% CI 1.22-12.91) than blacks.

Interestingly, using a bivariate analysis, Vandermeer told meeting attendees here, researchers found that "people who were vaccinated against influenza were actually more likely to die." She speculated that people with underlying health conditions may have been more likely to have been vaccinated. In the bivariate model, vaccination was associated with a 2.26-fold increased risk of death (95% CI 1.30-3.95). Cardiovascular disease was also a significant risk factor for death in this model (OR 2.57; 95% CI 1.61-4.08), but not in the multivariable analysis.

She concluded that statins are a promising area for further exploration and may be a useful adjunct to antiviral medications and vaccines. "However, our results do not say that people should be put on statins if they are hospitalized for influenza. There is definitely a need for randomized controlled trials to look at this further."

Vandermeer said in an interview that she has data about which statins patients were taking but has not analyzed them yet to try to discern whether any particular ones were more protective than others against death from influenza. A stumbling block to that analysis may be the low number of deaths recorded as part of the study and the variety of statins used.

The results of the study were based on patients with seasonal influenza two years ago. "So it's hard to say whether or not those results would extrapolate to the pandemic situation," Vandermeer cautioned, "although the mechanisms should be similar . . . but we definitely need those randomized, controlled trials before we say for sure to go ahead and use statins."

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