Statins Reduce Infection Risk in Stroke Patients

A new study shows that hospitalized patients on statins have a significantly lower risk of developing infections than those put on statins later in their hospitalization, or not at all.

Researchers at Washington State University (Spokane, WA, USA) conducted a study that retrospectively analyzed 1,612 consecutive acute care hospital electronic medical records (EMRs). In all, 1,151 patients were assigned to the exposed cohort, either when statin use preceded infection or statin medication was used, but no infection developed. A further 461 patients were assigned to the unexposed cohort, which included patients not on statins or initiating statins after infection developed.

The results showed that infection developed in 20% of the statin-exposed patients, and in 41% of the statin-unexposed patients. Overall, exposure to statins reduced the odds for developing nosocomial infection by 58%, compared to no exposure. The researchers found that while statins lowered infection risk for both sexes, for patients with a nasogastric tube, and for patients with dysphagia, they did not change infection risk for patients with endotracheal intubation. The study was published on June 9, 2016, in The Journal of Stroke and Cerebrovascular Disease.

“If patients had statins before there was evidence of an infection, there was a reduced risk that they would actually develop an infection,” said lead author adjunct professor Douglas Weeks, PhD. “The administration of statins relative to infection is critically important. We've been able to establish that if statins are given early, before infection can occur, the risk of infection is substantially reduced. However, this relationship needs to be tested in more rigorous placebo-controlled studies to see if this benefit with statins is maintained.”

Statins lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver. Randomized controlled trials have shown that they are most effective in those with cardiovascular disease (CVD), with questionable benefit in those without previous CVD but with elevated cholesterol levels. Statins also have immunomodulatory and peripheral anti-inflammatory properties that are independent of their lipid-lowering action.

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