Statins May Prevent Sepsis in Heart Patients

Risk of deadly reaction to infection was reduced by cholesterol drugs, study says

WEDNESDAY, Jan. 25, 2006 (HealthDay News) -- The cholesterol-lowering drugs called statins may lower the risk of developing sepsis -- a potentially fatal reaction to infection -- by 19 percent in patients with heart disease, a new Canadian study suggests.

"Patients who are treated with statins enjoy not only a reduction in their risk of heart attack and strokes, but a reduced risk of sepsis," said lead researcher by Dr. Donald Redelmeier, from Sunnybrook and Women's Hospital, in Ontario.

The findings appear in the Jan. 25 early online edition of The Lancet.

Sepsis is the body's response to infection. Patients who have sepsis can progress from being ill to seriously ill, to organ dysfunction and failure, and then to septic shock and death. People with heart disease have an increased risk of sepsis.

More than two people die every minute from severe sepsis in the United States. It is the leading cause of death among patients in intensive care units, and is responsible for more deaths than breast, colorectal, pancreatic and prostate cancer combined, according to the Society of Critical Care Medicine.

For the new study, Redelmeier's group collected data on 69,168 patients over age 65 with heart disease. All had been hospitalized for acute coronary syndrome, stroke or a revascularization procedure. Half of the patients had been prescribed statins after discharge, and half had not.

The researchers found that after two years, 551 patients taking statins were hospitalized for sepsis, compared with 667 patients not taking these drugs. That represented a 19 percent reduction in the risk of sepsis among those taking statins, Redelmeier's team noted.

If the finding is replicated in other trials, Redelmeier believes the use of statins may be important in reducing the risk of sepsis in any patient undergoing complex surgery. "Patients who are at risk for sepsis should not have their statin discontinued, contrary to standard therapy in intensive-care units," he said.

In addition, patients undergoing high-risk surgery should consider taking statins to prevent sepsis, Redelmeier said. "Patients with high degree of immunocompromise may want to consider statins for primary prevention," he noted.

One expert thinks additional studies are needed to prove whether statins really do reduce the risk of sepsis.

"This study is an addition to the growing literature suggesting that statins have anti-inflammatory properties that may be beneficial in acute life-threatening conditions, such as sepsis or acute lung injury," said Dr. Edward Abraham, the Roger Sherman Mitchell Professor of Pulmonary and Critical Care Medicine at the University of Colorado School of Medicine.

Animal and cell studies have indicated that statins can diminish the severity of sepsis, Abraham said. "There are now several epidemiologic studies, including this one, that suggest that statins may also be protective in patients with severe infections. While these studies are highly interesting, the utility of statins in reducing organ dysfunction and improving survival in sepsis can only be proven in a prospective study examining their use in severely ill patients with overwhelming infection," he added.

Another expert agrees that the new findings are inconclusive.

"It is hard to control for all the factors that might lead a clinician to prescribe statins," said Dr. Harlan M. Krumholz, a professor of cardiology at Yale University School of Medicine. "It may be that in an older population, patients who have better functional status are seen as more likely to have a hearty constitution, so the ones who receive statins are the people better able to tolerate sepsis,"

Krumholz said the new research should not be used to change medical practice.

"The findings do bear further evaluation," he said. "But they should not be considered definitive. These findings are more important to researchers than to patients and clinicians, and they should not affect practice."

More information

The Society of Critical Care Medicine can tell you more about sepsis.

SOURCES: Donald Redelmeier, M.D., Sunnybrook and Women's Hospital, Ontario, Canada; Edward Abraham, M.D., Roger Sherman Mitchell Professor of Pulmonary and Critical Care Medicine, University of Colorado, Denver; Harlan M. Krumholz, M.D., professor, cardiology, Yale University School of Medicine, New Haven, Conn.; Jan. 25, 2006, The Lancet online
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