Statin use and risk of COPD exacerbation requiring hospitalization

Meng Ting Wang, Yu Wen Lo, Cheng Liang Tsai, Li Chien Chang, Daniel C Malone, Che Li Chu, Jun Ting Liou

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Background: Despite recent studies that suggested statins' beneficial effects on chronic obstructive pulmonary disease (COPD) outcomes, the impact, if any, of statins on COPD exacerbations remains unclear. This study aimed to examine the association between statin use and risk of hospitalized COPD exacerbation, and to assess whether the association varied by statin initiation, dose, or duration of use. Methods: A retrospective nested case-control study among patients with COPD was conducted analyzing a nationwide health insurance claims database in Taiwan. Cases were subjects hospitalized for COPD exacerbations; each case was matched to 4 randomly selected controls on age, sex, cohort entry, and number of COPD-related outpatient visits by an incident-density sampling approach. Conditional logistic regressions were employed to quantify the COPD exacerbation risk associated with statin use. Results: The study cohort comprised 14,316 COPD patients, from which 1584 cases with COPD exacerbations and 5950 matched controls were identified. Any use of statins was associated with a 30% decreased risk of COPD exacerbation (95% confidence interval [CI], 0.56-0.88), and current use of statins was related to a greater reduced risk (adjusted odds ratio [OR] 0.60; 95% CI, 0.44-0.81). A dose-dependent reduced risk of COPD exacerbation by statins was observed (medium average daily dose: adjusted OR 0.60; 95% CI, 0.41-0.89; high daily dose: adjusted OR 0.33; 95% CI, 0.14-0.73). The reduced risk remained significant for either short or long duration of statin use. Conclusions: Statin use was associated with a reduced risk of COPD exacerbation, with a further risk reduction for statins prescribed more recently or at high doses.

Original languageEnglish (US)
Pages (from-to)598-606
Number of pages9
JournalAmerican Journal of Medicine
Volume126
Issue number7
DOIs
StatePublished - Jul 2013

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Chronic Obstructive Pulmonary Disease
Disease Progression
Hospitalization
Confidence Intervals
Odds Ratio
Risk Reduction Behavior
Health Insurance
Taiwan
Case-Control Studies
Cohort Studies
Outpatients

Keywords

  • Chronic obstructive pulmonary disease
  • Exacerbations
  • Nested case-control study
  • Pharmacoepidemiology
  • Statins

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wang, M. T., Lo, Y. W., Tsai, C. L., Chang, L. C., Malone, D. C., Chu, C. L., & Liou, J. T. (2013). Statin use and risk of COPD exacerbation requiring hospitalization. American Journal of Medicine, 126(7), 598-606. https://doi.org/10.1016/j.amjmed.2013.01.036

Statin use and risk of COPD exacerbation requiring hospitalization. / Wang, Meng Ting; Lo, Yu Wen; Tsai, Cheng Liang; Chang, Li Chien; Malone, Daniel C; Chu, Che Li; Liou, Jun Ting.

In: American Journal of Medicine, Vol. 126, No. 7, 07.2013, p. 598-606.

Research output: Contribution to journalArticle

Wang, MT, Lo, YW, Tsai, CL, Chang, LC, Malone, DC, Chu, CL & Liou, JT 2013, 'Statin use and risk of COPD exacerbation requiring hospitalization', American Journal of Medicine, vol. 126, no. 7, pp. 598-606. https://doi.org/10.1016/j.amjmed.2013.01.036
Wang, Meng Ting ; Lo, Yu Wen ; Tsai, Cheng Liang ; Chang, Li Chien ; Malone, Daniel C ; Chu, Che Li ; Liou, Jun Ting. / Statin use and risk of COPD exacerbation requiring hospitalization. In: American Journal of Medicine. 2013 ; Vol. 126, No. 7. pp. 598-606.
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AU - Lo, Yu Wen

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AU - Chang, Li Chien

AU - Malone, Daniel C

AU - Chu, Che Li

AU - Liou, Jun Ting

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AB - Background: Despite recent studies that suggested statins' beneficial effects on chronic obstructive pulmonary disease (COPD) outcomes, the impact, if any, of statins on COPD exacerbations remains unclear. This study aimed to examine the association between statin use and risk of hospitalized COPD exacerbation, and to assess whether the association varied by statin initiation, dose, or duration of use. Methods: A retrospective nested case-control study among patients with COPD was conducted analyzing a nationwide health insurance claims database in Taiwan. Cases were subjects hospitalized for COPD exacerbations; each case was matched to 4 randomly selected controls on age, sex, cohort entry, and number of COPD-related outpatient visits by an incident-density sampling approach. Conditional logistic regressions were employed to quantify the COPD exacerbation risk associated with statin use. Results: The study cohort comprised 14,316 COPD patients, from which 1584 cases with COPD exacerbations and 5950 matched controls were identified. Any use of statins was associated with a 30% decreased risk of COPD exacerbation (95% confidence interval [CI], 0.56-0.88), and current use of statins was related to a greater reduced risk (adjusted odds ratio [OR] 0.60; 95% CI, 0.44-0.81). A dose-dependent reduced risk of COPD exacerbation by statins was observed (medium average daily dose: adjusted OR 0.60; 95% CI, 0.41-0.89; high daily dose: adjusted OR 0.33; 95% CI, 0.14-0.73). The reduced risk remained significant for either short or long duration of statin use. Conclusions: Statin use was associated with a reduced risk of COPD exacerbation, with a further risk reduction for statins prescribed more recently or at high doses.

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