
Abstract Background The evidence regarding effects of statins on exacerbation risk in COPD remains controversial. Previous studies often excluded patients with cardiovascular comorbidities despite their high prevalence in COPD and role for exacerbations. Based on the cardioprotective properties of statins, we hypothesised that statins may reduce the risk of exacerbations especially in patients with cardiovascular comorbidities. Methods One thousand eight hundred eighty seven patients of the German COPD cohort COSYCONET (COPD and Systemic Consequences Comorbidities Network) of GOLD grades 1–4 (37.8% female, mean age 64.78 ± 8.3) were examined at baseline and over a period of 4.5 years for the occurrence of at least one exacerbation or severe exacerbation per year in cross-sectional and longitudinal analyses adjusted for age, gender, BMI, GOLD grade and pack-years. Due to their collinearity, various cardiovascular diseases were tested in separate analyses, whereby the potential effect of statins in the presence of a specific comorbidity was tested as interaction between statins and comorbidity. We also identified patients who never took statins, always took statins, or initiated statin intake during the follow-up. Results One thousand three hundred six patients never took statins, 31.6% were statin user, and 12.9% initiated statins during the follow-up. Most cardiovascular diseases were significantly (p < 0.05)may associated with an increased risk of COPD exacerbations, but in none of them the intake of statins was a significant attenuating factor, neither overall nor in modulating the increased risk linked to the specific comorbidities. The results of the cross-sectional and longitudinal analyses were consistent with each other, also those regarding at least 1 exacerbation or at least 1 severe exacerbation per year. Conclusion These findings complement the existing literature and may suggest that even in patients with COPD, cardiovascular comorbidities and a statin therapy that targets these comorbidities, the effects of statins on exacerbation risk are either negligible or more subtle than a reduction in exacerbation frequency. Trial registration Trial registration ClinicalTrials.gov, Identifier: NCT01245933. Other Study ID (BMBF grant): 01GI0881, registered 18 November 2010, study start 2010–11, primary completion 2013–12, study completion 2023–09. https://clinicaltrials.gov/study/NCT01245933?cond=COPD&term=COSYCONET&rank=3
Male, Cardiovascular Diseases/drug therapy [MeSH] ; Female [MeSH] ; Disease Progression [MeSH] ; Follow-Up Studies [MeSH] ; Pulmonary Disease, Chronic Obstructive/epidemiology [MeSH] ; Aged [MeSH] ; COPD ; Exacerbations ; Humans [MeSH] ; Longitudinal Studies [MeSH] ; Cardiovascular Diseases/epidemiology [MeSH] ; Middle Aged [MeSH] ; Statins ; Cross-Sectional Studies [MeSH] ; Cardiovascular Diseases/prevention ; Germany/epidemiology [MeSH] ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use [MeSH] ; Pulmonary Disease, Chronic Obstructive/drug therapy [MeSH] ; Cohort Studies [MeSH] ; Male [MeSH] ; Cardiovascular comorbidities ; Pulmonary Disease, Chronic Obstructive/diagnosis [MeSH] ; Research ; Comorbidity [MeSH], 610, Comorbidity, Exacerbations, Cohort Studies, Diseases of the respiratory system, Pulmonary Disease, Chronic Obstructive, Cardiovascular comorbidities, Germany, COPD, Humans, Longitudinal Studies, Aged, RC705-779, Research, Statins, Middle Aged, Cross-Sectional Studies, Cardiovascular Diseases, Disease Progression, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Follow-Up Studies
Male, Cardiovascular Diseases/drug therapy [MeSH] ; Female [MeSH] ; Disease Progression [MeSH] ; Follow-Up Studies [MeSH] ; Pulmonary Disease, Chronic Obstructive/epidemiology [MeSH] ; Aged [MeSH] ; COPD ; Exacerbations ; Humans [MeSH] ; Longitudinal Studies [MeSH] ; Cardiovascular Diseases/epidemiology [MeSH] ; Middle Aged [MeSH] ; Statins ; Cross-Sectional Studies [MeSH] ; Cardiovascular Diseases/prevention ; Germany/epidemiology [MeSH] ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use [MeSH] ; Pulmonary Disease, Chronic Obstructive/drug therapy [MeSH] ; Cohort Studies [MeSH] ; Male [MeSH] ; Cardiovascular comorbidities ; Pulmonary Disease, Chronic Obstructive/diagnosis [MeSH] ; Research ; Comorbidity [MeSH], 610, Comorbidity, Exacerbations, Cohort Studies, Diseases of the respiratory system, Pulmonary Disease, Chronic Obstructive, Cardiovascular comorbidities, Germany, COPD, Humans, Longitudinal Studies, Aged, RC705-779, Research, Statins, Middle Aged, Cross-Sectional Studies, Cardiovascular Diseases, Disease Progression, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Follow-Up Studies
| selected citations These citations are derived from selected sources. This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 2 | |
| popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Top 10% | |
| influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
| impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Average |
