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Statin for Tuberculosis and Pneumonia in Patients with Asthma–Chronic Pulmonary Disease Overlap Syndrome: A Time-Dependent Population-Based Cohort Study

by 1,2,3,4,*, 5,6, 7, 8 and 7,9,10,*
1
Department of Family and Chest Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
2
Department of Childhood Education and Nursery, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
3
Department of Family Medicine, China Medical University, Taichung 40447, Taiwan
4
Department of Nursing, Mei-Ho University, Pingtung 91252, Taiwan
5
Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan
6
College of Medicine, China Medical University, Taichung 40447, Taiwan
7
Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung 40447, Taiwan
8
Department of Computer Science and Information Engineering, Asia University, Taichung 40447, Taiwan
9
Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 40447, Taiwan
10
Department of Bioinformatics and Medical Engineering, Asia University, Taichung 40447, Taiwan
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(11), 381; https://doi.org/10.3390/jcm7110381
Received: 4 October 2018 / Revised: 20 October 2018 / Accepted: 23 October 2018 / Published: 24 October 2018
(This article belongs to the Section Pulmonology)
We investigated the effects of statins on tuberculosis (TB) and pneumonia risks in asthma–chronic pulmonary disease overlap syndrome (ACOS) patients. We extracted data of patients diagnosed as having ACOS during 2000–2010 from the Taiwan National Health Insurance Research Database and divided them into statin users and nonusers. All study participants were followed up from the index date until death, withdrawal from insurance, or TB and pneumonia occurred (31 December 2011). The cumulative TB and pneumonia incidence was analyzed using Cox proportional regression analysis with time-dependent variables. After adjustments for multiple confounding factors including age, sex, comorbidities, and use of medications [statins, inhaled corticosteroids (ICSs), or oral steroids (OSs)], statin use was associated with significantly lower TB [adjusted hazard ratio (aHR) 0.49, 95% confidence interval (CI) 0.34–0.70] and pneumonia (aHR 0.52, 95% CI 0.41–0.65) risks. Moreover, aHRs (95% CIs) for statins combined with ICSs and OSs were respectively 0.60 (0.31–1.16) and 0.58 (0.40–0.85) for TB and 0.61 (0.39–0.95) and 0.57 (0.45–0.74) for pneumonia. Thus, statin users had lower TB and pneumonia risks than did nonusers, regardless of age, sex, comorbidities, and ICS or OS use. Pneumonia risk was lower among users of statins combined with ICSs or Oss and TB risk was lower among the users of statins combined with OSs. View Full-Text
Keywords: tuberculosis; asthma–chronic pulmonary disease overlap syndrome; statins; pneumonia tuberculosis; asthma–chronic pulmonary disease overlap syndrome; statins; pneumonia
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Yeh, J.-J.; Lin, C.-L.; Hsu, C.-Y.; Shae, Z.; Kao, C.-H. Statin for Tuberculosis and Pneumonia in Patients with Asthma–Chronic Pulmonary Disease Overlap Syndrome: A Time-Dependent Population-Based Cohort Study. J. Clin. Med. 2018, 7, 381.

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