Statin use and infections in Veterans with cirrhosis

Authors

  • C. Motzkus-Feagans,

    1. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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  • A. L. Pakyz,

    1. Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA
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  • S. M. Ratliff,

    1. Department of Family Medicine and Community Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, USA
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  • J. S. Bajaj,

    1. Department of Family Medicine and Community Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, USA
    2. Division of Gastroenterology, Hepatology and Nutrition, McGuire Veterans Affairs Medical Center, Richmond, VA, USA
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  • K. L. Lapane

    Corresponding author
    • Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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Correspondence to:

Dr K. L. Lapane, Department of Quantitative Health Sciences, University of Massachusetts, 55 Lake Avenue North, ASC Building; 7th Floor, Room 7-2071, Worcester, MA, USA.

E-mail: kate.lapane@umassmed.edu

Summary

Background

Evidence about the beneficial effects of statins on reducing infections is accumulating. Identifying ways to reduce infection risk in patients with cirrhosis is important because of increased mortality risk and costs associated with infections.

Aim

To estimate the extent to which statin use prolongs time to infection among patients with cirrhosis.

Methods

We identified Veterans with cirrhosis, but without decompensation (n = 19 379) using US Veterans Health Administration data from 2001 to 2009. New users of statins were identified and propensity matched to non-users and users of other cholesterol-lowering medications (1:1 matching). The cohort was followed up for hospitalisations with infections. Cox regression models with time-varying exposures provided estimates of adjusted hazard ratios (HR) and 95% confidence intervals (CI).

Results

New statin use was present among 13% of VA patients with cirrhosis without decompensation. Overall, 12.4% of patients developed a serious infection, and 0.1% of patients died. In the propensity-matched sample, statin users experienced hospitalisations with infections at a rate 0.67 less than non-users (95% Confidence Interval: 0.47–0.95).

Conclusions

Infections are a major concern among cirrhotic patients and have the potential to seriously impact both life expectancy and quality of life. Statin use may potentially reduce the risk of infections among patients with cirrhosis.

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