Is Statin Use Associated with Reduced Mortality After Pneumonia? A Systematic Review and Meta-analysis

OBJECTIVE: The objective of this study was to perform a systematic review and meta-analysis of the effects of statins on mortality following pneumonia. METHODS: We searched MEDLINE, EMBASE, BIOSIS, Cochrane CENTRAL Register of Controlled Trials, Cambridge Scientific Abstracts, BIOSIS, and Scopus. Studies were included if they involved: participants >= 18 years of age; patients with community-acquired pneumonia; current statin users; and reported overall or adjusted mortality after pneumonia. RESULTS: Of 491 citations identified, 13 studies involving 254,950 patients met eligibility criteria. Pooled unadjusted data showed that statin use was associated with lower mortality after pneumonia (odds ratio [OR] 0.62, 95% confidence interval [CI], 0.54-0.71). Pooling of adjusted data also showed reduced mortality after pneumonia (OR 0.66, 95% CI, 0.55-0.79). However, this effect was attenuated in subgroup analysis by confounders and in prospective studies. CONCLUSIONS: Although statin use is associated with decreased mortality after pneumonia, this effect weakens in important subgroups. Only a randomized controlled study can fully explore the link between statins and pneumonia mortality. (C) 2012 Elsevier Inc. All rights reserved. The American Journal of Medicine (2012) 125, 1111-1123