Table 1

Characteristics of included studies

Author, place, date of publication

Study design

Study purpose

Statin exposed group

Controls

Outcome measurements


Lee T-M, et al., Taiwan, 2008[19]

Randomized, double-blinded, placebo-controlled trial

To investigate whether pravastatin administration is effective in improving exercise capacity in patients with COPD, and whether baseline or serial changes in hs-CRP over time are associated with corresponding changes in exercise capacity.

n = 62 patients with clinically stable COPD, received pravastatin (40 mg/day) over a period of 6 months (randomly assigned, double blind).

n = 63 patients with clinically stable COPD, received placebo over a period of 6 months (randomly assigned, double blind).

Exercise capacity

CRP/IL-6

Secondary outcome measurements:

Lung function

Borg dyspnea score after exercise tests


Blamoun AI et al, USA, 2008 [27]

Cohort study

To assess the rate of COPD exacerbations and intubations in COPD patients taking statins

n = 90 patients with primary or secondary diagnosis of COPD who were taking statins at the time of hospital admission and during the 1-year follow-up

n = 95 patients with primary or secondary diagnosis of COPD who were not taking statins at the time of hospital admission and during the 1-year follow-up

COPD exacerbations

Intubations secondary to COPD exacerbation


Van Gestel YR et al., Netherlands, 2008 [21]

Cohort study

To examine the relation between statins and mortality (within 30 days and 10 years) in a group of patients who underwent surgery for peripheral arterial disease and compare results in those with versus without associated COPD

COPD group:

n = 330 COPD patients who underwent elective vascular surgery and who did use statins

COPD group:

n = 980 COPD patients who underwent elective vascular surgery and who did use statins

All-cause mortality, short- and long-term (within 30 days and 10 years of follow-up respectively)


S√łyseth V et al., Norway, 2007[22]

Cohort study

To determine whether statins alone or in combination with inhaled steroids improve survival after COPD exacerbation

n = 118

patients with a diagnosis of COPD exacerbation at hospital discharge who were taking statins at the time of discharge

n = 736

patients with a diagnosis of COPD exacerbation at hospital discharge who were not taking statins at the time of discharge

All-cause mortality


Frost FJ et al., USA, 2007 [20]

Cohort study, and separate case-control studies (for influenza and COPD deaths)

To assess whether statin users have reduced mortality risks from influenza and COPD

Cohort study:

n = 19,058; patients with statin exposure

Case control study:

n = 207; COPD deaths (in hospital)

Cohort study:

n = 57,174; patients with no history of statin therapy

Case-control study:

n = 9,622; surviving patients with either an inpatient or outpatient diagnosis of COPD

Mortality from COPD (and influenza, not included in this review)


Keddissi JI, et al., USA, 2007 [26]

Cohort study

To assess the ability of statins to preserve lung function in current and former smokers and to reduce the incidence of respiratory-related urgent care

n = 215; statin users who were smokers or ex-smokers and had abnormal baseline spirometry (majority with obstructive spirometry findings, but restrictive findings also included).

n = 203; non-statin users who were smokers or ex-smokers and had abnormal baseline spirometry (obstruction or restriction)

Lung function (annual decline in FEV1 and FVC)

Respiratory-related ED-visits and hospitalizations


Mancini GB et al., Canada, 2006 [25]

Nested case-control study (time-matched)

To determine if statins, angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers reduce total mortality, COPD hospitalisations and myocardial infarctions in COPD patients

Two distinct COPD cohorts:

1) n = 2983 (sum of cases analysed for different endpoints, n = 3231 when steroid users included), high cardiovascular risk cohort (COPD patients having undergone coronary revascularization)

2) n = 7617 (sum of cases analysed for different endpoints, n = 8240 when steroid users included), low cardiovascular risk cohort (COPD patients without previous myocardial infarction and newly treated with nonsteroidal anti-inflammatory drug)

from same databases as study population, matched for age and year of cohort entry and still at risk of the event (endpoint)

n = 59,170 for cohort 1 (sum of controls for different endpoints, n = 64,185 including steroid users)

n = 152,177 for cohort 2 (sum of controls for different endpoints, n = 164,672 including steroid users)

COPD hospitalizations

Myocardial infarction

All-cause mortality


Ishida W, et al., Japan, 2007 [23]

Ecological analysis

To assess effects of statin use on mortality from major causes of death (cardiovascular diseases, COPD, pneumonia etc.)

COPD deaths in the >65 yrs old population in each of the 47 prefectures of Japan

No control

Mortality from COPD (and other major diseases), related to statin sales in the same area


Dobler et al. BMC Pulmonary Medicine 2009 9:32   doi:10.1186/1471-2466-9-32

Open Data