Consider The Evidence: Med/Peds Journal Roundup

February 6, 2006

Statins for sepsis???

Filed under: critical care, lancet, sepsis, statins, Uncategorized — medblog @ 11:21 pm

Lancet 2/4 – They slice, they dice, they even make julienne fries…Adding to the list of potential uses of statins is sepsis. In this weeks Lancet, Hackam et al., (as well as an accompanying editorial) investigate the evidence supporting a lower risk of sepsis in those patients on statin treatment. The study is a large retrospective cohort trial including patients over 65 admitted for an ACS related event or revascularization. 33 percent recieved statins. Each statin user was matched to a non-statin user by age sex and date. the final cohort included 69000+ patieints. Cases and controls had similar rates of comorbitities and sepsis risk factors.
Result – “We observed that the use of statins in patients older than 65 years with atherosclerosis was associated with a 19% reduction in the risk of sepsis. The apparent protective association between statins and sepsis was consistent across several high-risk subgroups, was apparent throughout the entire follow-up period.”
The authors state that they were not able to determine why certain controls were not given statin therapy. I wonder if physicians are less likely to start statins on sicker post-cath patients – maybe they opted to wait until patients were stable in order to restart maintenance meds, and those that were less stable were more likely to go on to get sepsis?
Seems to make a strong case to start some RCTs on the subject.

Statins and sepsis in patients with cardiovascular disease: a population-based cohort analysis. The Lancet, Volume 367, Issue 9508, Pages 413-418 D. Hackam, M. Mamdani, P. Li, D. Redelmeier


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