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Title: Effect of statin use on outcomes of adults with candidemia
Author: Cuervo Requena, Guillermo
García Vidal, Carolina
Nucci, Mario
Puchades, Francesc
Fernández Ruiz, Mario
Mykietiuk, Analía
Manzur, Adriana
Gudiol González, Carlota
Pemán, Javier
Viasus, Diego
Ayats, Josefina
Carratalà, Jordi
Keywords: HMG-CoA reductases
Medicaments antifúngics
Hydroxymethylglutaryl coenzyme A reductases
Antifungal agents
Issue Date: 14-Oct-2013
Publisher: Public Library of Science (PLoS)
Abstract: Background: Statins have immunomodulatory properties and hinder Candida growth. However, it is unknown whether they may improve prognosis in patients with candidemia. We sought to determine the effect of prior statin use on the clinical outcomes of patients suffering candidemia. Methods and Findings: Multicenter cohort study of hospitalized adults with candidemia between 2005 and 2011 in six hospitals in Spain, Brazil and Argentina. Of 326 candidemias, 44 (13.5%) occurred in statin users and 282 (86.5%) in statin non-users. The median value of APACHE II at candidemia diagnosis was similar between groups (18 vs. 16; p=.36). Candida albicans was the most commonly isolated species, followed by C. parapsilosis, C. tropicalis, C. glabrata, and C. krusei. There were no differences regarding appropriate empirical antifungal treatment. Statin users had a lower early (5 d) case-fatality rate than non-users (4.5 vs. 17%; p=.031). This effect was not observed with other cardiovascular drugs (aspirin, beta blockers and ACE inhibitors). Independent factor related to early case-fatality rate was APACHE II score (AOR, 1.08; 95% CI, 1.03-1.14; p=.002). An appropriate empirical antifungal therapy (AOR, 0.11; 95% CI, 0.04-0.26; p=<.001) and prior statin use were independently associated with lower early case-fatality (AOR, 0.17; 95% CI, 0.03-0.93; p=.041). Fourteen days (14d) and overall (30d) case-fatality rates were similar between groups (27% vs. 29%; p=0.77 and 40% vs. 44%; p=.66). Conclusions: The use of statins might have a beneficial effect on outcomes of patients with candidemia. This hypothesis deserves further evaluation in randomized trials.
Note: Reproducció del document publicat a: 10.1371/journal.pone.0077317
It is part of: PLoS One, 2013, vol. 8, num. 10, p. e77317
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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