Statin Use and Reduced Risk of Pneumonia in Patients with Melioidosis: A Lung-Specific Statin Association
Issued Date
2024-02-01
Resource Type
eISSN
23256621
Scopus ID
2-s2.0-85184149082
Pubmed ID
37862263
Journal Title
Annals of the American Thoracic Society
Volume
21
Issue
2
Start Page
228
End Page
234
Rights Holder(s)
SCOPUS
Bibliographic Citation
Annals of the American Thoracic Society Vol.21 No.2 (2024) , 228-234
Suggested Citation
Coston T.D., Wright S.W., Phunpang R., Dulsuk A., Thiansukhon E., Chaisuksant S., Tanwisaid K., Chuananont S., Morakot C., Sangsa N., Chayangsu S., Silakun W., Buasi N., Chetchotisakd P., Day N.P.J., Lertmemongkolchai G., Chantratita N., West T.E. Statin Use and Reduced Risk of Pneumonia in Patients with Melioidosis: A Lung-Specific Statin Association. Annals of the American Thoracic Society Vol.21 No.2 (2024) , 228-234. 234. doi:10.1513/AnnalsATS.202306-552OC Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/97156
Title
Statin Use and Reduced Risk of Pneumonia in Patients with Melioidosis: A Lung-Specific Statin Association
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
Udon Thani Center Hospital
Surin Hospital
Srinagarind hospital
Khon Kaen University
University of Washington
Khon Kaen Regional Hospital
Nuffield Department of Medicine
Chiang Mai University
Division of Pediatric Critical Care Medicine
Division of Pulmonary
Nakhon Phanom Hospital
Buriram Hospital
Sisaket Hospital
Roi Et Hospital
Mukdahan Hospital
Udon Thani Center Hospital
Surin Hospital
Srinagarind hospital
Khon Kaen University
University of Washington
Khon Kaen Regional Hospital
Nuffield Department of Medicine
Chiang Mai University
Division of Pediatric Critical Care Medicine
Division of Pulmonary
Nakhon Phanom Hospital
Buriram Hospital
Sisaket Hospital
Roi Et Hospital
Mukdahan Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Rationale: 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) use is associated with a lower risk of incident pneumonia and, less robustly, with nonpulmonary infections. Whether statin use is associated with a lower risk of pneumonia than other clinical presentations of infection with the same pathogen is unknown. Objectives: To assess whether preadmission statin use is associated with a lower risk of pneumonia than nonpneumonia presentations among patients hospitalized with Burkholderia pseudomallei infection (melioidosis). Methods: We performed a secondary analysis of a prospective multicenter cohort study of patients hospitalized with culture-confirmed B. pseudomallei infection (melioidosis). We used Poisson regression with robust standard errors to test for an association between statin use and pneumonia. We then performed several sensitivity analyses that addressed healthy user effect and indication bias. Results: Of 1,372 patients with melioidosis enrolled in the parent cohort, 1,121 were analyzed. Nine hundred eighty (87%) of 1,121 were statin nonusers, and 141 (13%) of 1,121 were statin users. Forty-six (33%) of 141 statin users presented with pneumonia compared with 432 (44%) of 980 statin nonusers. Statin use was associated with a lower risk of pneumonia in unadjusted analysis (relative risk, 0.74; 95% confidence interval, 0.58-0.95; P = 0.02) and, after adjustment for demographic variables, comorbidities, environmental exposures, and symptom duration (relative risk, 0.73; 95% confidence interval, 0.57-0.94; P = 0.02). The results of sensitivity analyses, including active comparator analysis and inverse probability of treatment weighting, were consistent with the primary analysis. Conclusions: In hospitalized patients with melioidosis, preadmission statin use was associated with a lower risk of pneumonia than other clinical presentations of melioidosis, suggesting a lung-specific protective effect of statins.