Association between statins use and mortality in critically ill patients with sepsis included myocardial injury: a retrospective cohort study

Abstract

Abstract Background The treatment of patients with sepsis included myocardial injury (SIMI) remains a subject of debate. Given the pharmacological effects of statins in both sepsis and cardiovascular disease, this study aimed to investigate the association between statins use and the prognosis of SIMI. Methods Patients with SIMI were primarily identified from the MIMIC-IV database. The patients were categorized into statins use and non-statins use groups, followed by propensity score matching (PSM) analysis to address baseline discrepancies between the groups. Univariate and multivariate Cox regression analyses were employed to assess the impact of statins on the prognosis of SIMI patients. The primary endpoint was 28-day all-cause mortality, with secondary outcomes including 90-day and 1-year all-cause mortality. To investigate whether the effects of certain factors vary across subgroups, subgroup analyse were performed. Results The cohorts before and after PSM comprised 2550 and 1368 patients, respectively. In the PSM cohort, statins use was associated with a reduced 28-day all-cause mortality (hazard ratio [HR] = 0.65, 95% confidence interval [CI] 0.53–0.79, P < 0.001), 90-day all-cause mortality (HR = 0.65, 95% CI 0.54–0.77, P < 0.001), and 1-year all-cause mortality (HR = 0.72, 95% CI (0.53–0.79), P < 0.001). In addition, subgroup analyse suggested potential interactions between statins use and factors such as chronic kidney disease (CKD). Conclusions Statins use is associated with a reduced short-term and long-term all-cause mortality rates in patients with SIMI.

Keywords

• Statins
• Sepsis included myocardial injury
• Mortality