Key result
Prior atorvastatin treatment did not reduce the incidence of hospital-acquired pneumonia but was associated with lower mortality in ventilator-associated pneumonia.
Why the study?
Does prior atorvastatin treatment reduce the frequency of hospital acquired pneumonia and mortality in patients with acute ischemic stroke?
Cohort (n=492)
Yes
Does prior atorvastatin treatment reduce the frequency of hospital acquired pneumonia and mortality in patients with acute ischemic stroke?
Prior atorvastatin treatment in severe acute ischemic stroke patients does not reduce overall hospital-acquired pneumonia or 28-day mortality, but is associated with lower inflammatory biomarkers and improved survival in those who develop ventilator-associated pneumonia.
Answers are grounded in this paper and cite their sources.
Should not change pneumonia prophylaxis in acute ischemic stroke; leaves open a mortality benefit in ventilator-associated pneumonia for prospective testing.
Objective . To investigate whether prior treatment of atorvastatin reduces the frequency of hospital acquired pneumonia (HAP). Methods . Totally, 492 patients with acute ischemic stroke and Glasgow Coma Scale ≤ 8 were enrolled in this study. Subjects were assigned to prior atorvastatin treatment group (n=268, PG) and no prior treatment group (n=224, NG). All the patients were given 20 mg atorvastatin every night during their hospital stay. HAP frequency and 28-day mortality were measured. Levels of inflammatory biomarkers [white blood cell (WBC), procalcitonin (PCT), tumor necrosis factor-alpha (TNF- α ), and interleukin-6 (IL-6)] were tested. Results . There was no significant difference in the incidence of HAP between PG and NG (25.74% versus. 24.55%,p>0.05) and 28-day mortality (50.72% versus 58.18%,p>0.05). However, prior statin treatment did modify the mortality of ventilator associated pneumonia (VAP) (36.54% versus 58.14%,p=0.041) and proved to be a protective factor (HR, 0.564; 95% CI, 0.310~0.825,p=0.038). Concentrations of TNF- α and IL-6 in PG VAP cases were lower than those in NG VAP cases (p<0.01). Conclusions . Prior atorvastatin treatment in patients with ischemic stroke was associated with a lower concentration of IL-6 and TNF- α and improved the outcome of VAP. This clinical study has been registered with ChiCTR-ROC-17010633 in Chinese Clinical Trial Registry.
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Yu et al. (2017) conducted a cohort in Acute ischemic stroke (n=492). Prior atorvastatin treatment vs. No prior atorvastatin treatment was evaluated on frequency of hospital acquired pneumonia (HAP) (p=>0.05). Prior atorvastatin treatment did not reduce the incidence of hospital-acquired pneumonia but was associated with lower mortality in ventilator-associated pneumonia.
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