The host response in critically ill sepsis patients on statin therapy: a prospective observational study
Abstract Background Statins can exert pleiotropic anti-inflammatory, vascular protective and anticoagulant effects, which in theory could improve the dysregulated host response during sepsis. We aimed to determine the association between prior statin use and host response characteristics in critical...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-01-01
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| Series: | Annals of Intensive Care |
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| Online Access: | http://link.springer.com/article/10.1186/s13613-017-0349-3 |
| _version_ | 1818840393315254272 |
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| author | Maryse A. Wiewel Brendon P. Scicluna Lonneke A. van Vught Arie J. Hoogendijk Aeilko H. Zwinderman René Lutter Janneke Horn Olaf L. Cremer Marc J. Bonten Marcus J. Schultz Tom van der Poll |
| author_facet | Maryse A. Wiewel Brendon P. Scicluna Lonneke A. van Vught Arie J. Hoogendijk Aeilko H. Zwinderman René Lutter Janneke Horn Olaf L. Cremer Marc J. Bonten Marcus J. Schultz Tom van der Poll |
| author_sort | Maryse A. Wiewel |
| collection | DOAJ |
| description | Abstract Background Statins can exert pleiotropic anti-inflammatory, vascular protective and anticoagulant effects, which in theory could improve the dysregulated host response during sepsis. We aimed to determine the association between prior statin use and host response characteristics in critically ill patients with sepsis. Methods We performed a prospective observational study in 1060 patients admitted with sepsis to the mixed intensive care units (ICUs) of two hospitals in the Netherlands between January 2011 and July 2013. Of these, 351 patients (33%) were on statin therapy before admission. The host response was evaluated by measuring 23 biomarkers providing insight into key pathways implicated in sepsis pathogenesis and by analyzing whole-blood leukocyte transcriptomes in samples obtained within 24 h after ICU admission. To account for indication bias, a propensity score-matched cohort was created (N = 194 in both groups for protein biomarkers and N = 95 in both groups for gene expression analysis). Results Prior statin use was not associated with an altered mortality up to 90 days after admission (38.0 vs. 39.7% in the non-statin users in the propensity-matched analysis). Statin use did not modify systemic inflammatory responses, activation of the vascular endothelium or the coagulation system. The blood leukocyte genomic response, characterized by over-expression of genes involved in inflammatory and innate immune signaling pathways as well as under-expression of genes associated to T cell function, was not different between patients with and without prior statin use. Conclusions Statin therapy is not associated with a modified host response in sepsis patients on admission to the ICU. |
| first_indexed | 2024-12-19T04:09:28Z |
| format | Article |
| id | doaj.art-7f71ced340e74ecabcd1f3ef29234c59 |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-19T04:09:28Z |
| publishDate | 2018-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-7f71ced340e74ecabcd1f3ef29234c592022-12-21T20:36:27ZengSpringerOpenAnnals of Intensive Care2110-58202018-01-018111210.1186/s13613-017-0349-3The host response in critically ill sepsis patients on statin therapy: a prospective observational studyMaryse A. Wiewel0Brendon P. Scicluna1Lonneke A. van Vught2Arie J. Hoogendijk3Aeilko H. Zwinderman4René Lutter5Janneke Horn6Olaf L. Cremer7Marc J. Bonten8Marcus J. Schultz9Tom van der Poll10Center for Experimental and Molecular Medicine, Academic Medical Center, University of AmsterdamCenter for Experimental and Molecular Medicine, Academic Medical Center, University of AmsterdamCenter for Experimental and Molecular Medicine, Academic Medical Center, University of AmsterdamCenter for Experimental and Molecular Medicine, Academic Medical Center, University of AmsterdamDepartment of Clinical Epidemiology, Bioinformatics, and Biostatistics, Academic Medical Center, University of AmsterdamDepartment of Respiratory Medicine and Experimental Immunology, Academic Medical Center, University of AmsterdamDepartment of Intensive Care, Academic Medical Center, University of AmsterdamDepartment of Intensive Care Medicine, University Medical Center UtrechtJulius Center for Health Sciences and Primary Care, University Medical Center UtrechtDepartment of Intensive Care, Academic Medical Center, University of AmsterdamCenter for Experimental and Molecular Medicine, Academic Medical Center, University of AmsterdamAbstract Background Statins can exert pleiotropic anti-inflammatory, vascular protective and anticoagulant effects, which in theory could improve the dysregulated host response during sepsis. We aimed to determine the association between prior statin use and host response characteristics in critically ill patients with sepsis. Methods We performed a prospective observational study in 1060 patients admitted with sepsis to the mixed intensive care units (ICUs) of two hospitals in the Netherlands between January 2011 and July 2013. Of these, 351 patients (33%) were on statin therapy before admission. The host response was evaluated by measuring 23 biomarkers providing insight into key pathways implicated in sepsis pathogenesis and by analyzing whole-blood leukocyte transcriptomes in samples obtained within 24 h after ICU admission. To account for indication bias, a propensity score-matched cohort was created (N = 194 in both groups for protein biomarkers and N = 95 in both groups for gene expression analysis). Results Prior statin use was not associated with an altered mortality up to 90 days after admission (38.0 vs. 39.7% in the non-statin users in the propensity-matched analysis). Statin use did not modify systemic inflammatory responses, activation of the vascular endothelium or the coagulation system. The blood leukocyte genomic response, characterized by over-expression of genes involved in inflammatory and innate immune signaling pathways as well as under-expression of genes associated to T cell function, was not different between patients with and without prior statin use. Conclusions Statin therapy is not associated with a modified host response in sepsis patients on admission to the ICU.http://link.springer.com/article/10.1186/s13613-017-0349-3StatinsSepsisHost responseBiomarkersMortality |
| spellingShingle | Maryse A. Wiewel Brendon P. Scicluna Lonneke A. van Vught Arie J. Hoogendijk Aeilko H. Zwinderman René Lutter Janneke Horn Olaf L. Cremer Marc J. Bonten Marcus J. Schultz Tom van der Poll The host response in critically ill sepsis patients on statin therapy: a prospective observational study Annals of Intensive Care Statins Sepsis Host response Biomarkers Mortality |
| title | The host response in critically ill sepsis patients on statin therapy: a prospective observational study |
| title_full | The host response in critically ill sepsis patients on statin therapy: a prospective observational study |
| title_fullStr | The host response in critically ill sepsis patients on statin therapy: a prospective observational study |
| title_full_unstemmed | The host response in critically ill sepsis patients on statin therapy: a prospective observational study |
| title_short | The host response in critically ill sepsis patients on statin therapy: a prospective observational study |
| title_sort | host response in critically ill sepsis patients on statin therapy a prospective observational study |
| topic | Statins Sepsis Host response Biomarkers Mortality |
| url | http://link.springer.com/article/10.1186/s13613-017-0349-3 |
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