Statin Use and Risk of COPD Exacerbation Requiring Hospitalization

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Statin Use and Risk of COPD Exacerbation Requiring Hospitalization Meng-Ting Wang, PhD, RPh, Yu-Wen Lo, MS, BPharm, Cheng-Liang Tsai, MD, Li-Chien Chang, PhD, Daniel C. Malone, PhD, RPh, Che-Li Chu, MS, BPharm, Jun-Ting Liou, MD The American Journal of Medicine Volume 126, Issue 7, Pages 598-606.e2 (July 2013) DOI: 10.1016/j.amjmed.2013.01.036 Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 1 Study flow diagram. COPD = chronic obstructive pulmonary disease. The American Journal of Medicine 2013 126, 598-606.e2DOI: (10.1016/j.amjmed.2013.01.036) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 2 Risk of hospitalization for chronic obstructive pulmonary disease (COPD) exacerbations in the sensitivity analyses. * P <.05. †The effect of nonstatin lipid-lowering agents on COPD exacerbations was estimated with nonuse of any lipid-lowering agent as the reference group. ACEI = angiotensin-converting enzyme inhibitors; ARB = angiotensin receptor blockers; CHD = coronary heart disease; CI = confidence interval; OR = odds ratio. The American Journal of Medicine 2013 126, 598-606.e2DOI: (10.1016/j.amjmed.2013.01.036) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 3 Sensitivity analysis assessing the strengths of associations between an unmeasured confounder of smoking and statin use and risk of chronic obstructive pulmonary disease (COPD) exacerbations that would explain our observed protective effect of statin use on COPD exacerbation (Adjusted odds ratio [Adj OR] = 0.70) or its upper 95% confidence limit (Adj OR = 0.88). Any combination of RRCD and OREC values resulting in points lower than and to the left of the solid line would be able to explain our main finding. OREC = association between statin use and smoking; RRCD = association between smoking and risk of COPD exacerbations. The American Journal of Medicine 2013 126, 598-606.e2DOI: (10.1016/j.amjmed.2013.01.036) Copyright © 2013 Elsevier Inc. Terms and Conditions