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Original Research |

The impact of statin use on all-cause mortality in patients with COPD: a population based cohort study

A.J.N. Raymakers, MSc; M. Sadatsafavi, PhD; D.D. Sin, MD; M.A. De Vera, PhD; L.D. Lynd, PhD
Author and Funding Information

Disclosures: AR, MS, DS, and MDV declare no conflicts of interest. LL has provided research methodology consultation to Teva, Pfizer, and Novartis.

1Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia (Vancouver, Canada)

2Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia (Vancouver, Canada)

3Centre for Heart and Lung Innovation, St. Paul's Hospital (Vancouver, Canada)

4Centre for Health Evaluation & Outcome Sciences (CHEOS), St Paul’s Hospital (Vancouver, Canada)

Corresponding Author: Larry Lynd Collaboration for Outcomes Research and Evaluation Faculty of Pharmaceutical Sciences 2405 Wesbrook Mall Vancouver, British Columbia, Canada.


Copyright 2017, . All Rights Reserved.


Chest. 2017. doi:10.1016/j.chest.2017.02.002
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Abstract

Background  Patients with chronic obstructive disease (COPD) are often prescribed statins due to the increased prevalence of cardiovascular disease (CVD). There is considerable debate about the benefits conferred by statins in patients with COPD. This study evaluates the association of statin use with all-cause and pulmonary-related mortality in COPD patients.

Methods  This study uses population-based administrative data for the province of British Columbia, Canada. A cohort of COPD patients was identified based on individual patients’ prescription records. Statin exposure was ascertained in the 1-year period after COPD ‘diagnosis’. The primary and secondary outcomes, all-cause and pulmonary-related mortality, respectively, were evaluated in the 1-year period thereafter using multivariate Cox proportional hazards models and several definitions of medication exposure.

Results  There were 39,678 COPD patients that met the study inclusion criteria. Of these, 7,775 (19.6%) had received at least one statin dispensed in the exposure ascertainment window. There were 1446 all-cause deaths recorded within the cohort in the 1-year period after exposure ascertainment. In multivariate analysis, the estimated hazard ratio for statin exposure was 0.79 (95% CI: 0.67-0.92, p=0.0016) suggesting a 21% reduction in the risk from statin use on all-cause mortality. For pulmonary-related mortality, there was also a considerable reduction in the risk all-cause mortality from statin use (HR: 0.55, 95: CI: 0.32-0.93, p=0.02454). These results were robust to different specifications of the exposure ascertainment window.

Conclusions  This study shows that statin use in a population-based cohort of COPD patients may confer benefits in terms of reduced pulmonary-related and all-cause mortality.


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