Abstract 16215: Statin Use in Asymptomatic Patients With Sepsis and Elevated Troponin is Associated With Lower Risk of Mortality
Background: In sepsis, patients frequently develop elevated levels of troponins. It is not clear if statin therapy in these patients improves outcomes. We examined the association of statin use at discharge with mortality in septic patients with elevated troponin.
Methods: We examined 936 consecutive patients diagnosed with sepsis who had elevated troponin levels on admission. Patients with septic shock were excluded. Statin use was defined by the presence of documentation that statin prescription was provided at discharge. Cox proportional hazard models adjusted for demographics and clinical covariates examined the association of statin use with all-cause mortality.
Results: Of 936 patients, there were 344 (36.8%) individuals treated with statin therapy. There were 108 (31.4%) deaths in statin users and 236 (41.0%) among non-statin users. The mean peak troponin level was 1.00 ± 0.09 ng/ml. In a Cox model adjusted for age, sex, race, peak troponin, hypertension, diabetes, known coronary artery disease, known end stage renal disease, known stroke, hyperlipidemia, use of anticoagulation during the hospitalization, use of antiplatelet during hospitalization, use of antiplatelet at discharge, use of anticoagulation at discharge, and beta blocker use at discharge, statin use was associated with lower risk of mortality (HR 0.46; 95% CI 0.35, 0.61, p <0.0001). The association was much stronger among individuals with troponin >1 ng/dl (HR 0.19, 95% CI 0.08, 0.44, p = 0.0001 vs. HR 0.52; 95% CI 0.39, 0.69, p <0.0001; interaction p = 0.0001). Kaplan-Meier’s plot is shown in figure 1.
Conclusions: Among septic patients with elevated troponin, statin use was associated with lower risk of mortality. This protective association was much stronger in patients with troponin levels >1. Future research should focus on its use in septic patients in a randomized trial.
Author Disclosures: A.H. Mullis: None. H.R. Jogu: None. M.I. Ahmad: None. A. Feroz: None. V. Mendapara: None. M.M. Saleh: None. R.S. Elfawal: None. N.R. Onteddu: None. W.T. Qureshi: None.
- © 2016 by American Heart Association, Inc.