Key result
Statin use was associated with a 28% reduction in 1-year mortality (HR 0.72) compared to non-statin use in patients with sepsis-induced myocardial injury.
Why the study?
Sepsis-induced myocardial injury is a critical complication of sepsis with high mortality and lacking effective treatments, and the impact of statin therapy on mortality remains unclear.
Does statin therapy reduce mortality in adult patients with sepsis-induced myocardial injury?
Cohort (n=2,246)
No
Does statin therapy reduce mortality in adult patients with sepsis-induced myocardial injury?
Hazard Ratio: 0.72 (95% CI 0.58–0.9)
p-value: p=0.003
Statin use during the ICU stay is associated with significantly reduced short- and long-term mortality in patients with sepsis-induced myocardial injury.
May support statin use in sepsis-induced myocardial injury; hypothesis-generating and requires randomized confirmation.
Background: Sepsis-induced myocardial injury (SIMI) is a critical complication of sepsis, marked by high mortality rates, and lacks effective treatments. The impact of statin therapy on mortality in SIMI patients remains unclear. This study aims to explore the association between statin use and mortality in SIMI patients, focusing on both short-term and long-term outcomes. Methods: A retrospective cohort study was conducted by extracting SIMI patient information from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were categorized into statin and non-statin groups. A 1:1 nearest propensity-score matching (PSM) was used to balance baseline characteristics. Survival outcomes were assessed using Kaplan-Meier analysis and robust Cox proportional hazards models to understand the effects of statin use, type and dosage on mortality at 28 days, 90 days, and 1 year. E-Value analysis was used for unmeasured confounding. Results: A total of 2,246 patients meeting SIMI criteria were enrolled in the final cohort, with 17.9% receiving statins during their ICU stay. Statin use was associated with significantly lower mortality at all time points, as shown by Kaplan-Meier analysis. In multivariable robust Cox regression models, statin therapy correlated with a 32% reduction in 28-day mortality (HR = 0.68, 95% CI: 0.49-0.94), a 29% reduction at 90 days (HR = 0.71, 95% CI: 0.54-0.93), and a 28% reduction at 1 year (HR = 0.72, 95% CI: 0.58-0.90), maintaining significance after adjustment for confounders. Simvastatin was particularly effective, and low-dose statins were linked to reduced mortality risk. Subgroup analyses suggested consistent statin benefits. E-Value analysis suggested robustness to unmeasured confounding. Conclusion: Our study demonstrates that statin use is significantly associated with reduced mortality in SIMI patients across 28 days, 90 days, and 1 year. Simvastatin provides substantial benefits, with low-dose statins providing greater advantages compared to high-dose formulations.
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Liu et al. (2025) conducted a cohort in Sepsis-induced myocardial injury (SIMI) (n=2,246). Statin use vs. Non-statin use was evaluated on 1-year mortality (HR 0.72, 95% CI 0.58-0.90, p=0.003). Statin use was associated with a 28% reduction in 1-year mortality (HR 0.72) compared to non-statin use in patients with sepsis-induced myocardial injury.
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