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Table 1 Characteristics of included studies

From: Associations between statins and COPD: a systematic review

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)
Søyseth 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