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American Journal of the Medical Sciences:
doi: 10.1097/MAJ.0b013e31828318e2
Clinical Investigation

The Effect of Statin Therapy on the Incidence of Infections: A Retrospective Cohort Analysis

Magulick, John P. MD; Frei, Christopher R. PharmD, MSc; Ali, Sayed K. MD; Mortensen, Eric M. MD, MSc; Pugh, Mary Jo PhD; Oramasionwu, Christine U. PharmD, PhD; Daniels, Kelly R. PharmD; Mansi, Ishak A. MD

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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.

Copyright © 2013 by the Southern Society for Clinical Investigation

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