The effect of statin therapy on the incidence of infections: A retrospective cohort analysis

John P. Magulick, Chris Frei, Sayed K. Ali, Eric M. Mortensen, Mary Jo Pugh, Christine U. Oramasionwu, Kelly R. Daniels, Ishak A. Mansi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: Statins have been postulated to prevent infection through immunomodulatory effects. OBJECTIVES: To compare the incidence of infections in statin users to that in nonusers within the same health care system. METHODS: This was a retrospective cohort study of patients enrolled as Tricare Prime or Plus in the San Antonio military multimarket. Statin users were patients who received a statin for at least 3 months between October 1, 2004 and September 30, 2005. Nonusers were patients who did not receive a statin within the study period (October 1, 2003-September 30, 2009). Inpatient and outpatient International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes were used to determine the incidence of infections during the follow-up period (October 1, 2005-September 30, 2009) via multivariable regression analysis and time to infection via Cox regression analysis. RESULTS: Of 45,247 patients who met the study criteria, 12,981 (29%) were statin users and 32,266 were nonusers. After adjustments for age, gender, Charlson Comorbidity Score, tobacco use, alcohol abuse/dependence, health care utilization and use of specific medication classes, statin use was associated with an increased incidence of common infections (odds ratio [OR]: 1.13; 95% confidence interval [CI]: 1.06-1.19) but not influenza or fungal infections (OR: 1.06, 95% CI: 0.80-1.39; OR: 0.97; 95% CI: 0.91-1.04, respectively). Time-to-first infection was similar in statin users and nonusers in all infection categories examined. CONCLUSIONS: Statin use was associated with an increased incidence of common infections but not influenza or fungal infections. This study does not support a protective role of statins in infection prevention; however, the influence of potential confounders cannot be excluded.

Original languageEnglish (US)
Pages (from-to)211-216
Number of pages6
JournalAmerican Journal of the Medical Sciences
Volume347
Issue number3
DOIs
StatePublished - Mar 2014

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cohort Studies
Incidence
Infection
Therapeutics
Mycoses
Odds Ratio
Confidence Intervals
Human Influenza
Alcoholism
Patient Acceptance of Health Care
Regression Analysis
Tobacco Use
International Classification of Diseases
Comorbidity
Inpatients
Outpatients
Retrospective Studies
Delivery of Health Care

Keywords

  • Fungal
  • Infection
  • Influenza
  • Statin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Magulick, J. P., Frei, C., Ali, S. K., Mortensen, E. M., Pugh, M. J., Oramasionwu, C. U., ... Mansi, I. A. (2014). The effect of statin therapy on the incidence of infections: A retrospective cohort analysis. American Journal of the Medical Sciences, 347(3), 211-216. https://doi.org/10.1097/MAJ.0b013e31828318e2

The effect of statin therapy on the incidence of infections : A retrospective cohort analysis. / Magulick, John P.; Frei, Chris; Ali, Sayed K.; Mortensen, Eric M.; Pugh, Mary Jo; Oramasionwu, Christine U.; Daniels, Kelly R.; Mansi, Ishak A.

In: American Journal of the Medical Sciences, Vol. 347, No. 3, 03.2014, p. 211-216.

Research output: Contribution to journalArticle

Magulick, JP, Frei, C, Ali, SK, Mortensen, EM, Pugh, MJ, Oramasionwu, CU, Daniels, KR & Mansi, IA 2014, 'The effect of statin therapy on the incidence of infections: A retrospective cohort analysis', American Journal of the Medical Sciences, vol. 347, no. 3, pp. 211-216. https://doi.org/10.1097/MAJ.0b013e31828318e2
Magulick, John P. ; Frei, Chris ; Ali, Sayed K. ; Mortensen, Eric M. ; Pugh, Mary Jo ; Oramasionwu, Christine U. ; Daniels, Kelly R. ; Mansi, Ishak A. / The effect of statin therapy on the incidence of infections : A retrospective cohort analysis. In: American Journal of the Medical Sciences. 2014 ; Vol. 347, No. 3. pp. 211-216.
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abstract = "BACKGROUND: Statins have been postulated to prevent infection through immunomodulatory effects. OBJECTIVES: To compare the incidence of infections in statin users to that in nonusers within the same health care system. METHODS: This was a retrospective cohort study of patients enrolled as Tricare Prime or Plus in the San Antonio military multimarket. Statin users were patients who received a statin for at least 3 months between October 1, 2004 and September 30, 2005. Nonusers were patients who did not receive a statin within the study period (October 1, 2003-September 30, 2009). Inpatient and outpatient International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes were used to determine the incidence of infections during the follow-up period (October 1, 2005-September 30, 2009) via multivariable regression analysis and time to infection via Cox regression analysis. RESULTS: Of 45,247 patients who met the study criteria, 12,981 (29{\%}) were statin users and 32,266 were nonusers. After adjustments for age, gender, Charlson Comorbidity Score, tobacco use, alcohol abuse/dependence, health care utilization and use of specific medication classes, statin use was associated with an increased incidence of common infections (odds ratio [OR]: 1.13; 95{\%} confidence interval [CI]: 1.06-1.19) but not influenza or fungal infections (OR: 1.06, 95{\%} CI: 0.80-1.39; OR: 0.97; 95{\%} CI: 0.91-1.04, respectively). Time-to-first infection was similar in statin users and nonusers in all infection categories examined. CONCLUSIONS: Statin use was associated with an increased incidence of common infections but not influenza or fungal infections. This study does not support a protective role of statins in infection prevention; however, the influence of potential confounders cannot be excluded.",
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