Chest
CORRESPONDENCEMechanism of Statin-Associated Mortality Reduction in COPD
Section snippets
To the Editor
We read with interest the article by Frost et al (April 2007)1 reporting reduced mortality in COPD patients prescribed statins. The antiinflammatory properties of these drugs hold exciting promise in respiratory disease, especially COPD, in which there is heightened systemic inflammation associated with increased cardiovascular morbidity.2 There are currently no randomized trials of statins in COPD, and the mechanism underlying any mortality benefit remains unexplained. We recently performed a
References (3)
- et al.
Influenza and COPD mortality protection as pleiotropic, dose-dependent effects of statins
Chest
(2007)
Cited by (10)
Lipid profile and statin use: The paradox of survival after acute exacerbation of chronic obstructive pulmonary disease
2015, American Journal of the Medical SciencesCitation Excerpt :Whether low cholesterol has a direct negative impact on patients with COPD remains to be determined in further prospective studies. Statins reduce cholesterol levels by inhibiting 3-hydroxy- 3-methylglutaryl coenzyme A (HMG-CoA) reductase and have an established role in the treatment of atherosclerotic disease.14,15 The therapeutic effect of statins on cardiovascular and autoimmune disease seems to be broadly anti-inflammatory, which is also likely to apply to lung diseases in which there is an inflammatory component.11–13
Statin use and risk of COPD exacerbation requiring hospitalization
2013, American Journal of MedicineCitation Excerpt :These limitations were addressed in our study. The diverse immune modulating6,8 and anti-inflammatory actions6,7 of statins might be the plausible mechanism accounting for the observed risk reduction of COPD exacerbations. In addition to inhibition of endogenous cholesterol synthesis, statins have been reported to exert strong immunomodulating effects.8,10
Cardiovascular disease in COPD: Mechanisms
2013, ChestCitation Excerpt :Intervention with statins has been reported to reduce major cardiovascular events in patients with increased systemic inflammation in some studies, including a large prospective randomized controlled trial,17,18 but not in a post hoc analysis of the Anglo-Scandinavian Cardiac Outcomes Trial.19 In a retrospective study of pharmacy dispensing data, statin prescriptions were associated with reduced mortality in patients with COPD,20 and statins have been shown to reduce the levels of systemic inflammatory markers in this condition.21 As in COPD, other conditions associated with systemic inflammation have increased cardiovascular risk, such as rheumatoid arthritis.22
Treatment of COPD: Moving beyond the lungs
2012, Current Opinion in PharmacologyCitation Excerpt :Whether statins have a beneficial effect in COPD patients by primarily reducing cardiovascular complications or because they exhibit an action directly targeting pulmonary inflammation is still a matter of controversy [31]. Intriguingly, Hurst et al. [32] reported that, while statins were associated with reduced plasma IL-6 concentration in patients with COPD and comorbid CVD, this might be not true in patients without CVD. Renin–angiotensin system (RAS) blockade exerts an anti-inflammatory action in many systems.
The mevalonate pathway and innate immune hyper-responsiveness in the pathogenesis of COPD and lung cancer: Potential for chemoprevention
2017, Current Molecular Pharmacology
Dr. Hurst has no conflict of interest to declare. Dr. Hagan is employed by GlaxoSmithKline. Dr. Wedzicha has received honoraria and research funding from GlaxoSmithKline.