The following is a summary of “Statins did not reduce the frequency of exacerbations in individuals with COPD and cardiovascular comorbidities in the COSYCONET cohort,” published in the May 2024 issue of Pulmonology by Frantzi et al.

The impact of statins on the exacerbation risk in patients with Chronic Obstructive Pulmonary Disease (COPD) remains debated. Prior studies have often excluded individuals with cardiovascular comorbidities despite the high prevalence of these conditions in patients with COPD and their potential role in exacerbations. Given the cardioprotective properties of statins, the researchers hypothesized that statins might reduce the risk of exacerbations, particularly in patients with cardiovascular comorbidities.

This study included 1,887 patients from the German COPD cohort COSYCONET (COPD and Systemic Consequences Comorbidities Network) spanning GOLD grades 1-4 (37.8% female, mean age 64.78 ± 8.3 years). Patients were assessed at baseline and followed for 4.5 years to record the occurrence of at least one exacerbation or severe exacerbation per year. Analyses were adjusted for age, gender, BMI, GOLD grade, and pack years. Due to collinearity, various cardiovascular diseases were tested separately to evaluate the potential effect of statins in the presence of specific comorbidities. The study group examined interactions between statin use and comorbidities, identifying patients who never used statins, those who always used statins, and those who initiated statin therapy during the follow-up period.

Of the patients studied, 1,306 never used statins, 31.6% were statin users, and 12.9% initiated statin therapy during the follow-up. Most cardiovascular diseases were significantly associated with an increased risk of COPD exacerbations (p < 0.05). However, statin use did not significantly mitigate this risk overall or in interaction with specific comorbidities. The cross-sectional and longitudinal analyses yielded consistent results, showing no significant reduction in the risk of experiencing at least one exacerbation or one severe exacerbation per year due to statin use.

These findings add to the existing literature and suggest that, even in patients with COPD suffering from cardiovascular comorbidities who are receiving statin therapy, the impact of statins on exacerbation risk is negligible or more subtle than expected. Statins do not significantly reduce the frequency of exacerbations in this population, indicating the need for further research to identify effective strategies for managing exacerbation risks in patients with COPD suffering from cardiovascular comorbidities.

Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-024-02822-1