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This Article Full Text (PDF) Free All Versions of this Article: chest.07-0298v1 132/6/1764    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Keddissi, J. Articles by Kinasewitz, G. Search for Related Content PubMed PubMed Citation Articles by Keddissi, J. Articles by Kinasewitz, G.

The Use of Statins and Lung Function in Current and Former Smokers.

Pulmonary and Critical Care Medicine, The Oklahoma City VA Medical Center and the University of Oklahoma Medical Center, Oklahoma City, OK

Jean-keddissi{at}ouhsc.edu

Jean-keddissi{at}ouhsc.edu

Abstract

BackgroundSmokers are affected by a variety of inflammatory diseases, including COPD. Statins, 3-hydroxy-3-methyl-glutaryl-coenzyme-A reductase inhibitors, are used for their lipid lowering characteristics, but also appear to have anti inflammatory and immunomodulatory activity. We assessed their ability to preserve lung function in current and former smokers.

MethodsAll smokers and ex-smokers seen at the Oklahoma City VA hospital in 2005, with abnormal baseline spirometry, and 2 or more pulmonary function tests (PFT) done 6 months apart were divided into obstructive, restrictive groups based on their initial PFT. Statin use, annual decline in FEV1 and FVC, need for Respiratory Related Urgent Care (emergency department or inpatient, RRUC) were compared.

ResultsApproximately half, 215 of 418 patients, were on a statin. Compared to the control group, statin users had a lower decline in FEV1 (-0.005+/-0.20 vs. 0.085+/-0.17 L/y, p<0.0001) and FVC (-0.046+/-0.45 vs. 0.135+/-0.32 L/y, p<0.0001). This difference remained significant irrespective of whether the patient had obstructive (n=319), or restrictive (n=99) disease, and regardless of whether the patient continued or stopped smoking. In patients with obstructive spirometry, we found a lower incidence of RRUC in favor of the statin group (0.12 ± 0.29 vs. 0.19 ± 0.32/patient-year, p=0.02).

ConclusionIn smokers and former smokers, statins are associated with a slower decline in pulmonary function, independent of the underlying lung disease.

Clinical implicationProspective, randomized trials are needed to study the effect of statins on lung function.

Key Words: statins • COPD • smokers • ex-smokers • pulmonary function tests