The online version of this article (https://doi.org/10.1186/s13613-017-0349-3) contains supplementary material, which is available to authorized users.
Statins can exert pleiotropic anti-inflammatory, vascular protective and anticoagulant effects, which in theory could improve the dysregulated host response during sepsis. We aimed to determine the association between prior statin use and host response characteristics in critically ill patients with sepsis.
We performed a prospective observational study in 1060 patients admitted with sepsis to the mixed intensive care units (ICUs) of two hospitals in the Netherlands between January 2011 and July 2013. Of these, 351 patients (33%) were on statin therapy before admission. The host response was evaluated by measuring 23 biomarkers providing insight into key pathways implicated in sepsis pathogenesis and by analyzing whole-blood leukocyte transcriptomes in samples obtained within 24 h after ICU admission. To account for indication bias, a propensity score-matched cohort was created (N = 194 in both groups for protein biomarkers and N = 95 in both groups for gene expression analysis).
Prior statin use was not associated with an altered mortality up to 90 days after admission (38.0 vs. 39.7% in the non-statin users in the propensity-matched analysis). Statin use did not modify systemic inflammatory responses, activation of the vascular endothelium or the coagulation system. The blood leukocyte genomic response, characterized by over-expression of genes involved in inflammatory and innate immune signaling pathways as well as under-expression of genes associated to T cell function, was not different between patients with and without prior statin use.
Statin therapy is not associated with a modified host response in sepsis patients on admission to the ICU.
Additional file 1: Figure 1. Flowchart of patients. Figure 2. Distribution of propensity scores. Figure 3. Blood transcriptomics of sepsis patients discordant for statin therapy. Table 1. Host response biomarkers in sepsis patients admitted to the ICU stratified according to prior use of statins in the unmatched cohort. Table 2. Baseline characteristics of matched statin-users and non-users in the gene expression study. Table 3. Outcomes of matched statin-users and non-users in the gene expression study.
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- The host response in critically ill sepsis patients on statin therapy: a prospective observational study
Maryse A. Wiewel
Brendon P. Scicluna
Lonneke A. van Vught
Arie J. Hoogendijk
Aeilko H. Zwinderman
Olaf L. Cremer
Marc J. Bonten
Marcus J. Schultz
Tom van der Poll
- Springer International Publishing
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