Statins for the Prevention and Treatment of Infections: A Systematic Review and Meta-analysis Export

@article{citeulike:5938506, abstract = {Background Emerging epidemiological evidence suggests that statin use may reduce the risk of infections and infection-related complications. Our objective was to examine the association between statin use and the risk of infections and related outcomes. Methods We searched several electronic databases from inception through December 2007 for randomized trials and cohort studies that examined the association between statin use and the risk or outcome of infections. Data on study characteristics, measurement of statin use, outcomes (adjusted for potential confounders), and quality assessment were extracted. Results Sixteen cohorts were eligible and differed in representativeness, outcome assessment, and comparability of exposed (statin) and unexposed (nonstatin) groups. Nine cohorts addressed the role of statins in treating infections: bacteremia (n = 3), pneumonia (n = 3), sepsis (n = 2), and bacterial infection (n = 1). The pooled adjusted effect estimate was 0.55 (95\% confidence interval, 0.36-0.83; I2 = 76.5\%) in favor of statins. Seven cohorts addressed infection prevention in patients with vascular diseases (n = 3), chronic kidney disease (n = 1), diabetes (n = 1), intensive care unit-acquired infections (n = 1), and in general practice (n = 1). The pooled effect estimate was 0.57 (95\% confidence interval, 0.43-0.75; I2 = 82\%) in favor of statin use; there was some evidence of publication bias for this analysis (Egger test; P = .07). Meta-regression did not identify potential effect modifiers that explain the between-study heterogeneity. Conclusions Results for our meta-analysis suggest that statin use may be associated with a beneficial effect in treating and preventing different infections. Given the presence of heterogeneity and publication bias, there is a need for randomized trials to confirm the benefit of statin use in this context. 10.1001/archinternmed.2009.286}, author = {Tleyjeh, Imad M. and Kashour, Tarek and Hakim, Fayaz A. and Zimmerman, Valerie A. and Erwin, Patricia J. and Sutton, Alex J. and Ibrahim, Talal}, citeulike-article-id = {5938506}, citeulike-linkout-0 = {http://dx.doi.org/10.1001/archinternmed.2009.286}, citeulike-linkout-1 = {http://archinte.ama-assn.org/content/169/18/1658.abstract}, citeulike-linkout-2 = {http://archinte.ama-assn.org/content/169/18/1658.full.pdf}, citeulike-linkout-3 = {http://view.ncbi.nlm.nih.gov/pubmed/19822822}, citeulike-linkout-4 = {http://www.hubmed.org/display.cgi?uids=19822822}, day = {12}, doi = {10.1001/archinternmed.2009.286}, journal = {Arch Intern Med}, keywords = {infection, meta-analysis, statin}, month = {October}, number = {18}, pages = {1658--1667}, posted-at = {2009-10-14 08:55:11}, priority = {2}, title = {Statins for the Prevention and Treatment of Infections: A Systematic Review and Meta-analysis}, url = {http://dx.doi.org/10.1001/archinternmed.2009.286}, volume = {169}, year = {2009} }

TY - JOUR ID - citeulike:5938506 L3 - citeulike-article-id:5938506 N2 - Background Emerging epidemiological evidence suggests that statin use may reduce the risk of infections and infection-related complications. Our objective was to examine the association between statin use and the risk of infections and related outcomes. Methods We searched several electronic databases from inception through December 2007 for randomized trials and cohort studies that examined the association between statin use and the risk or outcome of infections. Data on study characteristics, measurement of statin use, outcomes (adjusted for potential confounders), and quality assessment were extracted. Results Sixteen cohorts were eligible and differed in representativeness, outcome assessment, and comparability of exposed (statin) and unexposed (nonstatin) groups. Nine cohorts addressed the role of statins in treating infections: bacteremia (n = 3), pneumonia (n = 3), sepsis (n = 2), and bacterial infection (n = 1). The pooled adjusted effect estimate was 0.55 (95% confidence interval, 0.36-0.83; I2 = 76.5%) in favor of statins. Seven cohorts addressed infection prevention in patients with vascular diseases (n = 3), chronic kidney disease (n = 1), diabetes (n = 1), intensive care unit-acquired infections (n = 1), and in general practice (n = 1). The pooled effect estimate was 0.57 (95% confidence interval, 0.43-0.75; I2 = 82%) in favor of statin use; there was some evidence of publication bias for this analysis (Egger test; P = .07). Meta-regression did not identify potential effect modifiers that explain the between-study heterogeneity. Conclusions Results for our meta-analysis suggest that statin use may be associated with a beneficial effect in treating and preventing different infections. Given the presence of heterogeneity and publication bias, there is a need for randomized trials to confirm the benefit of statin use in this context. 10.1001/archinternmed.2009.286 IS - 18 JF - Arch Intern Med EP - 1667 TI - Statins for the Prevention and Treatment of Infections: A Systematic Review and Meta-analysis VL - 169 SP - 1658 KW - infection KW - meta-analysis KW - statin AU - Tleyjeh, Imad AU - Kashour, Tarek AU - Hakim, Fayaz AU - Zimmerman, Valerie AU - Erwin, Patricia AU - Sutton, Alex AU - Ibrahim, Talal PY - 2009/10/12/ UR - http://dx.doi.org/10.1001/archinternmed.2009.286 ER -