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CID 2006;43:199-205
Background: Published data on antiinflammatory and immunomodulatory effects of statins suggest they may reduce mortality risks associated with an unchecked immune response to selected infections, including influenza and COPD. We assessed whether statin users had reduced mortality risks from these conditions. Methods: We conducted a matched cohort study (n = 76,232) and two separate casecontrol studies (397 influenza and 207 COPD deaths) to evaluate whether statin therapy is associated with increased or decreased mortality risk and survival time using health-care encounter data for members of health maintenance organizations. For the cohort study, baseline illness risks from all causes prior to initiation of statin therapy were used to statistically adjust for the occurrence of outcomes after initiation of treatment. Results: For moderate-dose (> 4 mg/d) statin users, this cohort study found statistically significant reduced odds ratios (ORs) of influenza/pneumonia death (OR, 0.60; 95% confidence interval [CI],0.44 to 0.81) and COPD death (OR, 0.17; 95% CI, 0.07 to 0.42) and similarly reduced survival hazard ratios. Findings were confirmed with the case-control studies. Confounding factors not considered may explain some of the effects observed. Conclusions: This study found a dramatically reduced risk of COPD death and a significantly reduced risks of influenza death among moderate-dose statin users.
(CHEST 2007; 131:10061012)
Low compliance
Moderate compliance Without COPD-related deaths Low compliance
0.81 (0.441.51)
0.51 (0.300.89)*
0.45 (0.210.94)*
0.13 (0.050.32)*
0.99 (0.541.80)
Moderate compliance
0.54 (0.310.93)*
DOSIS RECOMENDADA Atorvastatina 80 mgs/da por 5 das en pacientes 16 aos. Atorvastatina 40 mgs/da por 5 das en pacientes de 13 a 15 aos (peso 40 kgs).
MEDICIONES DE SEGURIDAD
Si en algn momento, las mediciones de CPK son >10 x ULN > 5 X ULN y se acompaan de dolor muscular, dolor a la palpacin o debilidad inexplicables. Si se presentan niveles persistentes de TGO/ TGP >3 x ULN (2 mediciones con diferencia de 48 hrs).
Con el fin de cuidar la seguridad de los pacientes se desarroll un sistema electrnico de vigilancia .
OTRAS ACCIONES DE LA DPM CON EL FIN DE INCREMENTAR LA CALIDAD DEL SUSTENTO A LA ACTUAL RECOMENDACIN
Promocin y apoyo en forma independiente al desarrollo de un Ensayo clnico, aleatorizado, comparado contra placebo y triple ciego. Mismo que habr de iniciarse en las siguientes semanas en un nmero reducido de Hospitales.