Statins May Protect Against Flu-Related Death

Oh my god, another push for statins coming.
http://www.medpagetoday.com/InfectiousDisease/URItheFlu/30214?utm_source=cardiodaily&utm_medium=email&utm_content=aha&utm_campaign=12-14-11&eun=gd3r&userid=424561&email=oc1dean@yahoo.com&mu_id=

Action Points

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• This study found that statin users may get an additional benefit from the drug besides lower cholesterol levels -- a lower likelihood of dying after being hospitalized with influenza.
  



• Statin users were more likely to be older, male, and white; to suffer from cardiovascular, metabolic, renal, and chronic lung disease; and to have received that year's flu vaccine.
  

In addition to lower cholesterol levels, statin users may get another benefit from the drug: a lower likelihood of dying after being hospitalized with influenza, researchers found.

Among patients admitted with laboratory-confirmed influenza, those who used statins before or during the hospital stay had lower odds of dying within 30 days (OR 0.59, 95% CI 0.38 to 0.92), according to Ann Thomas, MD, MPH, of the Oregon Public Health Division in Portland, and colleagues.

The absolute risk of dying within 30 days was 3.9% among statin users and 5.5% among nonusers, the researchers reported in the Jan. 1 issue of the Journal of Infectious Diseases. Some of the findings were previously presented at the 2009 meeting of the Infectious Diseases Society of America.

"Although not the first study to note such an effect, this article adds significantly to the slowly accumulating evidence that statins may reduce the substantial annual morbidity and mortality from influenza," according to Edward Walsh, MD, of Rochester General Hospital in New York, who noted that the benefit may stem from the anti-inflammatory effects of the drugs.

But, he wrote in an accompanying editorial, without randomized trial evidence, "the potential benefit will remain debatable and open to the same criticisms regarding the value of influenza vaccines in the elderly and the value of antiviral therapy in hospitalized persons."

Thomas and her colleagues looked at data from the CDC's Emerging Infections Program, which collects information on patients hospitalized with lab-confirmed influenza in 59 counties spread among 10 states.

The current study was restricted to 3,043 adults (median age 70.4 years) hospitalized during the 2007-2008 flu season with a lab-confirmed infection. More than half (57.1%) had been vaccinated against influenza, although the vaccine was a poor match for circulating strains that year.

According to hospital charts, one-third of the patients were taking statins before admission or received them in the hospital. Statin users were more likely to be older, male, and white; to suffer from cardiovascular, metabolic, renal, and chronic lung disease; and to have received that year's flu vaccine.

Only after accounting for those differences, as well as the use of antivirals within 48 hours of admission, was statin use associated with lower odds of dying within 30 days of the influenza test. The mortality findings were similar for cutoffs of seven, 14, and 21 days.

The definitive test for whether statins have a role to play in lessening the impact of influenza is a randomized controlled trial, according to Thomas and colleagues.

Walsh said a trial evaluating long-term statin therapy to improve flu outcomes seems unlikely, and that a study evaluating the use of acute statin therapy for hospitalized statin-naïve patients is more likely.

The researchers acknowledged some limitations of their analysis, including the possibility that the patients are not representative of all patients hospitalized with influenza because of the requirement for lab confirmation, the reliance on data from chart review, the inability to determine statin use after hospital discharge, and possible confounding from unmeasured factors, such as underlying functional health status.

But, they wrote, "despite their limitations and the need for randomized controlled trials before statins can be widely promoted for the treatment of influenza, our findings suggest that statins are a promising area of exploration and could provide a useful adjunct to antiviral medications and vaccine, particularly in settings where circulating influenza virus strains are not susceptible to antiviral medications, or vaccine is in short supply or not well matched to circulating viruses."