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Current Reviews in Clinical and Experimental Pharmacology

Editor-in-Chief

ISSN (Print): 2772-4328
ISSN (Online): 2772-4336

Meta-Analysis

The Association between Statins Intake and Risk of Post Stroke Pneumonia: A Systematic Review and Meta-Analysis

Author(s): Mohammad Darvishi, Mehdi Mohammadian Amiri, Saeid Heidari-Soureshjani, Catherine M.T. Sherwin and Hossein Mardani-Nafchi*

Volume 19, Issue 3, 2024

Published on: 10 October, 2023

Page: [285 - 293] Pages: 9

DOI: 10.2174/0127724328258172230926070748

Price: $65

Open Access Journals Promotions 2
Abstract

Aim: This research aimed to examine the relationship between the intake of statins and the risk of post-stroke pneumonia in a systematic review and meta-analysis study.

Methods: An extensive search of published articles on March 21st, 2023, was done in several databases, like Web of Science (ISI), PubMed, Cochrane Library, Embase, Scopus, and Google Scholar. The Newcastle Ottawa Scale (NOS) checklist was employed to evaluate the quality of observational studies. Statistical tests (Chi-square test and I2) and graphical techniques (Forest plot) were used to determine whether heterogeneity existed in the meta-analysis studies. Funnel plots and Begg and Egger's tests were used to assess the publication bias.

Results: Seven studies (5 cohort and 2 case-control studies) were retrieved to examine the association between statins and post-stroke pneumonia. The sample size of the studies compiled in the meta- analysis was obtained to be 68,966 participants. Meta-analysis demonstrated that the overall odds of post-stroke pneumonia in the statin group was equal to 0.87 (95% CI: 0.67 – 1.13; p-value 0.458). Subgroup analysis indicated that the odds of post-stroke pneumonia in the statin group was equal to 0.93 (95% CI: 0.73-1.18; p-value = 0.558) in the cohort studies, and equal to 0.92 (95% CI: 0.37-2.26; p-value = 0.857) in the case-control studies. The examination of the association between the intake of statins and post-stroke pneumonia showed no evidence of publication bias (Begg's test, p-value = 0.368; Eggers test, p-value = 0.282).

Conclusion: In this study, no relationship has been observed between receiving statins and the risk of post-stroke pneumonia.

Keywords: Hydroxymethylglutaryl-CoA reductase inhibitors, stroke-associated pneumonia, meta-analysis, statins, stroke, pneumonia, systematic review.

« Previous
[1]
Badve MS, Zhou Z, van de Beek D, Anderson CS, Hackett ML. Frequency of post-stroke pneumonia: Systematic review and meta-analysis of observational studies. Int J Stroke 2019; 14(2): 125-36.
[http://dx.doi.org/10.1177/1747493018806196] [PMID: 30346258]
[2]
Matz K, Seyfang L, Dachenhausen A, Teuschl Y, Tuomilehto J, Brainin M. Post-stroke pneumonia at the stroke unit – a registry based analysis of contributing and protective factors. BMC Neurol 2016; 16(1): 107.
[http://dx.doi.org/10.1186/s12883-016-0627-y] [PMID: 27430328]
[3]
Safdar N, Crnich CJ, Maki DG. The pathogenesis of ventilator-associated pneumonia: Its relevance to developing effective strategies for prevention. Respir Care 2005; 50(6): 725-39.
[PMID: 15913465]
[4]
Grossmann I, Rodriguez K, Soni M, et al. Stroke and pneumonia: Mechanisms, risk factors, management, and prevention. Cureus 2021; 13(11): e19912.
[http://dx.doi.org/10.7759/cureus.19912] [PMID: 34984111]
[5]
McGwin G Jr, Xie A, Owsley C. The use of cholesterol-lowering medications and age-related macular degeneration. Ophthalmology 2005; 112(3): 488-94.
[http://dx.doi.org/10.1016/j.ophtha.2004.10.027] [PMID: 15745779]
[6]
Vavvas DG, Daniels AB, Kapsala ZG, et al. Regression of some high-risk features of age-related macular degeneration (AMD) in patients receiving intensive statin treatment. EBioMedicine 2016; 5: 198-203.
[http://dx.doi.org/10.1016/j.ebiom.2016.01.033] [PMID: 27077128]
[7]
Sizar O, Khare S, Jamil RT. Statin Medications. In: StatPearls. Treasure Island, FL: StatPearls Publishing 2022.
[8]
Yin Y, Zhang L, Marshall I, Wolfe C, Wang Y. Statin therapy for preventing recurrent stroke in patients with ischemic stroke: A systematic review and meta-analysis of randomized controlled trials and observational cohort studies. Neuroepidemiology 2022; 56(4): 240-9.
[http://dx.doi.org/10.1159/000525672] [PMID: 35753307]
[9]
Yuan M, Li Q, Zhang R, et al. Risk factors for and impact of poststroke pneumonia in patients with acute ischemic stroke. Medicine 2021; 100(12): e25213.
[http://dx.doi.org/10.1097/MD.0000000000025213] [PMID: 33761707]
[10]
Tavabe NR, Kheiri S, Dehghani M, Mohammadian-Hafshejani A. A systematic review and meta-analysis of the relationship between receiving the flu vaccine with acute cerebrovascular accident and its hospitalization in the elderly. BioMed Res Int 2023; 2023: 1-11.
[http://dx.doi.org/10.1155/2023/2606854] [PMID: 36814798]
[11]
Kang JH, Kao LT, Lin HC, Tsai MC, Chung SD. Statin use increases the risk of depressive disorder in stroke patients: A population-based study. J Neurol Sci 2015; 348(1-2): 89-93.
[http://dx.doi.org/10.1016/j.jns.2014.11.013] [PMID: 25483831]
[12]
Becker K, Tanzi P, Kalil A, Shibata D, Cain K. Early statin use is associated with increased risk of infection after stroke. J Stroke Cerebrovasc Dis 2013; 22(1): 66-71.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2011.06.008] [PMID: 21782466]
[13]
Song TJ, Kim J. Effect of statins on the risk of poststroke pneumonia: National population-based cohort study. Infect Drug Resist 2020; 13: 2689-98.
[http://dx.doi.org/10.2147/IDR.S258420] [PMID: 32982323]
[14]
Yu Y, Zhu C, Liu C, Gao Y. Effect of prior atorvastatin treatment on the frequency of hospital acquired pneumonia and evolution of biomarkers in patients with acute ischemic stroke: A multicenter prospective study. BioMed Res Int 2017; 2017: 1-8.
[http://dx.doi.org/10.1155/2017/5642704] [PMID: 28357403]
[15]
Kang JH, Kao LT, Lin HC, Wang TJ, Yang TY. Do outpatient statins and ACEIs/ARBs have synergistic effects in reducing the risk of pneumonia? A population-based case-control study. PLoS One 2018; 13(6): e0199981.
[http://dx.doi.org/10.1371/journal.pone.0199981] [PMID: 29953536]
[16]
Li C, Ma M, Dong S, et al. Statin treatment in the acute phase and the risk of post-stroke pneumonia: A retrospective cohort study. Front Neurol 2021; 12: 635079.
[http://dx.doi.org/10.3389/fneur.2021.635079] [PMID: 34552547]
[17]
Rodríguez de Antonio LA, Martínez-Sánchez P, Martínez-Martínez MM, et al. Previous statins treatment and risk of post-stroke infections. Neurología 2011; 26(3): 150-6.
[http://dx.doi.org/10.1016/S2173-5808(11)70031-1] [PMID: 21163226]
[18]
Adib-Hajbaghery MZM. The barriers to patient education from the viewpoint of nurses in IRAN: A systematic review. Nurs Midwifery J 2017; 15(7): 544-58.
[19]
Weeks DL, Greer CL, Willson MN. Statin medication use and nosocomial infection risk in the acute phase of stroke. J Stroke Cerebrovasc Dis 2016; 25(10): 2360-7.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.05.033] [PMID: 27292907]
[20]
Yun JH, Rhee SY, Chun S, Kim HS, Oh BM. Association between antihypertensive use and hospitalized pneumonia in patients with stroke: A Korean nationwide population-based cohort study. J Korean Med Sci 2022; 37(15): e112.
[http://dx.doi.org/10.3346/jkms.2022.37.e112] [PMID: 35437963]
[21]
Zhao Q, Shan W, Liu L, Fu X, Liu P, Hu Y. Predictors of functional outcome and hemorrhagic complications in acute ischemic stroke patients treated with intravenous thrombolysis – A retrospective analysis. Int J Clin Pharmacol Ther 2017; 55(12): 893-900.
[http://dx.doi.org/10.5414/CP203117] [PMID: 29092734]
[22]
Liu CL, Shau WY, Wu CS, Lai MS. Angiotensin converting enzyme inhibitor (ACEI)/ angiotensin ii receptor blockers (ARB) and pneumonia risk among stroke patients. Pharmacoepidemiol Drug Saf 2011; 20: S80.
[23]
Maier IL, Karch A, Mikolajczyk R. Bähr M, Liman J. Effect of beta-blocker therapy on the risk of infections and death after acute stroke--a historical cohort study. PLoS One 2015; 10(2): e0116836.
[http://dx.doi.org/10.1371/journal.pone.0116836] [PMID: 25643360]
[24]
Scheitz JF, Endres M, Heuschmann PU, Audebert HJ, Nolte CH. Reduced risk of poststroke pneumonia in thrombolyzed stroke patients with continued statin treatment. Int J Stroke 2015; 10(1): 61-6.
[http://dx.doi.org/10.1111/j.1747-4949.2012.00864.x] [PMID: 22973817]
[25]
Lin SP, Long YM, Chen XH. The effects of statins on infections after stroke or transient ischemic attack: A meta-analysis. PLoS One 2015; 10(7): e0130071.
[http://dx.doi.org/10.1371/journal.pone.0130071] [PMID: 26158560]
[26]
Cui C, Li Q, Li C, Zhao S, Li Y. Statin pretreatment combined with intravenous thrombolysis for ischemic stroke patients: A meta-analysis. J Clin Neurosci 2022; 98: 142-8.
[http://dx.doi.org/10.1016/j.jocn.2022.02.012] [PMID: 35180504]
[27]
Nielsen A, Nielsen R, Riis A, Johnsen S. Sّørensen H, Thomsen R. The impact of statin use on pneumonia risk and outcome: A combined population-based case-control and cohort study. Crit Care 2012; 16(4): R122.
[http://dx.doi.org/10.1186/cc11418] [PMID: 22789037]
[28]
Yun SJ, Byun SJ, Kim HJ, et al. Statin use and pneumonia risk in Parkinson’s disease. Parkinsonism Relat Disord 2021; 91: 124-7.
[http://dx.doi.org/10.1016/j.parkreldis.2021.09.021] [PMID: 34601341]
[29]
van de Garde EMW, Hak E, Souverein PC, Hoes AW, van den Bosch JMM, Leufkens HGM. Statin treatment and reduced risk of pneumonia in patients with diabetes. Thorax 2006; 61(11): 957-61.
[http://dx.doi.org/10.1136/thx.2006.062885] [PMID: 16809409]
[30]
Grudzinska FS, Dosanjh DPS, Parekh D, et al. Statin therapy in patients with community-acquired pneumonia. Clin Med 2017; 17(5): 403-7.
[http://dx.doi.org/10.7861/clinmedicine.17-5-403] [PMID: 28974587]
[31]
Piani F, Di Salvo E, Landolfo M, et al. Statin therapy may protect against acute kidney injury in patients hospitalized for interstitial SARS-CoV2 pneumonia. Nutr Metab Cardiovasc Dis 2023; 33(1): 227-31.
[http://dx.doi.org/10.1016/j.numecd.2022.10.005] [PMID: 36411214]
[32]
Viasus D, Garcia-Vidal C, Simonetti AF, et al. The effect of simvastatin on inflammatory cytokines in community-acquired pneumonia: A randomised, double-blind, placebo-controlled trial. BMJ Open 2015; 5(1): e006251.
[http://dx.doi.org/10.1136/bmjopen-2014-006251] [PMID: 25564143]
[33]
Iwata A, Shirai R, Ishii H, et al. Inhibitory effect of statins on inflammatory cytokine production from human bronchial epithelial cells. Clin Exp Immunol 2012; 168(2): 234-40.
[http://dx.doi.org/10.1111/j.1365-2249.2012.04564.x] [PMID: 22471285]
[34]
Liu Y, Ren H, Guo J, Su D. Effect of continuous nursing on nursing quality and patient quality of life and satisfaction among children with pneumonia. J Int Med Res 2021; 49(3): 03000-60521993691.
[http://dx.doi.org/10.1177/0300060521993691] [PMID: 33769134]
[35]
Henig O, Kaye KS. Bacterial pneumonia in older adults. Infect Dis Clin North Am 2017; 31(4): 689-713.
[http://dx.doi.org/10.1016/j.idc.2017.07.015] [PMID: 28916385]
[36]
Yang M, Yang Y, Liu L, et al. Sex differences in factors influencing hospital-acquired pneumonia in schizophrenia patients receiving modified electroconvulsive therapy. Front Psychiatry 2023; 14: 1127262.
[http://dx.doi.org/10.3389/fpsyt.2023.1127262] [PMID: 36865072]

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