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.
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.
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.
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.