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Impact of statins and ACE inhibitors on mortality after COPD exacerbations

BACKGROUND: The purpose of our study was to examine the association of prior outpatient use of statins and angiotensin converting enzyme (ACE) inhibitors on mortality for subjects ≥ 65 years of age hospitalized with acute COPD exacerbations. METHODS: We conducted a retrospective national cohort stud...

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Autores principales: Mortensen, Eric M, Copeland, Laurel A, Pugh, Mary Jo V, Restrepo, Marcos I, de Molina, Rosa Malo, Nakashima, Brandy, Anzueto, Antonio
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697974/
https://www.ncbi.nlm.nih.gov/pubmed/19493329
http://dx.doi.org/10.1186/1465-9921-10-45
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author Mortensen, Eric M
Copeland, Laurel A
Pugh, Mary Jo V
Restrepo, Marcos I
de Molina, Rosa Malo
Nakashima, Brandy
Anzueto, Antonio
author_facet Mortensen, Eric M
Copeland, Laurel A
Pugh, Mary Jo V
Restrepo, Marcos I
de Molina, Rosa Malo
Nakashima, Brandy
Anzueto, Antonio
author_sort Mortensen, Eric M
collection PubMed
description BACKGROUND: The purpose of our study was to examine the association of prior outpatient use of statins and angiotensin converting enzyme (ACE) inhibitors on mortality for subjects ≥ 65 years of age hospitalized with acute COPD exacerbations. METHODS: We conducted a retrospective national cohort study using Veterans Affairs administrative data including subjects ≥65 years of age hospitalized with a COPD exacerbation. Our primary analysis was a multilevel model with the dependent variable of 90-day mortality and hospital as a random effect, controlling for preexisting comorbid conditions, demographics, and other medications prescribed. RESULTS: We identified 11,212 subjects with a mean age of 74.0 years, 98% were male, and 12.4% of subjects died within 90-days of hospital presentation. In this cohort, 20.3% of subjects were using statins, 32.0% were using ACE inhibitors or angiotensin II receptor blockers (ARB). After adjusting for potential confounders, current statin use (odds ratio 0.51, 95% confidence interval 0.40–0.64) and ACE inhibitor/ARB use (0.55, 0.46–0.66) were significantly associated with decreased 90-day mortality. CONCLUSION: Use of statins and ACE inhibitors prior to admission is associated with decreased mortality in subjects hospitalized with a COPD exacerbation. Randomized controlled trials are needed to examine whether the use of these medications are protective for those patients with COPD exacerbations.
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spelling pubmed-26979742009-06-18 Impact of statins and ACE inhibitors on mortality after COPD exacerbations Mortensen, Eric M Copeland, Laurel A Pugh, Mary Jo V Restrepo, Marcos I de Molina, Rosa Malo Nakashima, Brandy Anzueto, Antonio Respir Res Research BACKGROUND: The purpose of our study was to examine the association of prior outpatient use of statins and angiotensin converting enzyme (ACE) inhibitors on mortality for subjects ≥ 65 years of age hospitalized with acute COPD exacerbations. METHODS: We conducted a retrospective national cohort study using Veterans Affairs administrative data including subjects ≥65 years of age hospitalized with a COPD exacerbation. Our primary analysis was a multilevel model with the dependent variable of 90-day mortality and hospital as a random effect, controlling for preexisting comorbid conditions, demographics, and other medications prescribed. RESULTS: We identified 11,212 subjects with a mean age of 74.0 years, 98% were male, and 12.4% of subjects died within 90-days of hospital presentation. In this cohort, 20.3% of subjects were using statins, 32.0% were using ACE inhibitors or angiotensin II receptor blockers (ARB). After adjusting for potential confounders, current statin use (odds ratio 0.51, 95% confidence interval 0.40–0.64) and ACE inhibitor/ARB use (0.55, 0.46–0.66) were significantly associated with decreased 90-day mortality. CONCLUSION: Use of statins and ACE inhibitors prior to admission is associated with decreased mortality in subjects hospitalized with a COPD exacerbation. Randomized controlled trials are needed to examine whether the use of these medications are protective for those patients with COPD exacerbations. BioMed Central 2009 2009-06-03 /pmc/articles/PMC2697974/ /pubmed/19493329 http://dx.doi.org/10.1186/1465-9921-10-45 Text en Copyright © 2009 Mortensen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Mortensen, Eric M
Copeland, Laurel A
Pugh, Mary Jo V
Restrepo, Marcos I
de Molina, Rosa Malo
Nakashima, Brandy
Anzueto, Antonio
Impact of statins and ACE inhibitors on mortality after COPD exacerbations
title Impact of statins and ACE inhibitors on mortality after COPD exacerbations
title_full Impact of statins and ACE inhibitors on mortality after COPD exacerbations
title_fullStr Impact of statins and ACE inhibitors on mortality after COPD exacerbations
title_full_unstemmed Impact of statins and ACE inhibitors on mortality after COPD exacerbations
title_short Impact of statins and ACE inhibitors on mortality after COPD exacerbations
title_sort impact of statins and ace inhibitors on mortality after copd exacerbations
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697974/
https://www.ncbi.nlm.nih.gov/pubmed/19493329
http://dx.doi.org/10.1186/1465-9921-10-45
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