The impact of statins, ACE inhibitors and gastric acid suppressants on pneumonia mortality in a UK general practice population cohort.

ABSTRACT

BACKGROUND: Pneumonia is a common diagnosis in general practice in the United Kingdom. Previous studies suggest that commonly prescribed drugs in general practice may influence pneumonia mortality. AIM: We investigated whether statins, angiotensin converting enzyme inhibitors (ACEIs), proton pump inhibitors (PPIs) and histamine-2-receptor antagonists (H(2)RAs) have an impact on short-term and long-term mortality in pneumonia cases. DESIGN OF STUDY Population-based cohort study SETTTING United Kingdom METHODS: Data on 3681 pneumonia cases above the age of 40 years were obtained from a comprehensive database called the health improvement network (THIN) which has computerised medical records from 300 general practice surgeries in the United Kingdom. We used Cox regression for our analyses. RESULTS: Current statin use was associated with a 67% decrease in 30-day mortality (adj. HR 0.33, 95% CI 0.19-0.58) and a 55% decrease in long-term mortality (adj. HR 0.45, 95% CI 0.32-0.62) over a median follow-up of 2.8 years as compared to no-use. Current ACEI use decreased the 30-day mortality risk by nearly 38% as compared to no-use (adj. HR 0.62, 95% CI 0.47-0.82) but was not associated with long-term mortality. No significant impact on mortality was observed for either gastric acid suppressant. CONCLUSION: The use of statins is associated with a lower risk of short- and long-term mortality following pneumonia whereas the use of ACEIs is associated with a decreased mortality risk only in the short-term.