Talal Alzahrani1,2, Angelike P Liappis1,2, Larry M Baddour3, Pamela E Karasik1. 1. Medical Service, Washington DC VA Medical Center, Washington, DC, USA. 2. Department of Medicine, George Washington University, Washington, DC, USA. 3. Division of Infectious Diseases, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: The rate of cardiovascular implantable electronic device infection (CIEDI) has increased, despite the use of perioperative antibiotics at the time of device placement or revision. This is due, in part, to the presence of multiple comorbid conditions in an elderly population, in general, who require CIED. Statins may have an antibacterial effect, although there is currently no evidence that the likelihood of CIEDI has been impacted by statin use. METHODS: A retrospective cohort study was performed to assess whether statins are associated with a reduced risk of CIEDI. The VA Informatics and Computing Infrastructure (VINCI) database, which includes all veterans who underwent CIED placement between 2008 and 2015, was used. A logistic regression model was constructed to estimate the adjusted risk of CIEDI among patients who were receiving statins after adjusting for confounding factors. RESULTS: Overall, 18,970 CIED procedures were included, and 98% of them were performed in men with a mean age of 71 ± 11 years. The rate of diabetes mellitus, heart failure, advanced chronic kidney diseases, CIEDI, positive methicillin-resistant Staphylococcus aureus nasal colonization, and statin use were 23%, 15.7%, 3.3%, 1.14%, 12.6%, and 56%, respectively. The logistic regression analysis showed that statins were significantly associated with a reduced risk of CIEDI; after controlling for other effects, the reduction was 66% (odds ratio 0.34 [0.2-0.59], P-value < 0.001). The effect of statins was confirmed by propensity score analysis. CONCLUSIONS: Our study showed that among patients receiving statins who had undergone CIED placement, there was a 66% reduction in subsequent CIEDI.
BACKGROUND: The rate of cardiovascular implantable electronic device infection (CIEDI) has increased, despite the use of perioperative antibiotics at the time of device placement or revision. This is due, in part, to the presence of multiple comorbid conditions in an elderly population, in general, who require CIED. Statins may have an antibacterial effect, although there is currently no evidence that the likelihood of CIEDI has been impacted by statin use. METHODS: A retrospective cohort study was performed to assess whether statins are associated with a reduced risk of CIEDI. The VA Informatics and Computing Infrastructure (VINCI) database, which includes all veterans who underwent CIED placement between 2008 and 2015, was used. A logistic regression model was constructed to estimate the adjusted risk of CIEDI among patients who were receiving statins after adjusting for confounding factors. RESULTS: Overall, 18,970 CIED procedures were included, and 98% of them were performed in men with a mean age of 71 ± 11 years. The rate of diabetes mellitus, heart failure, advanced chronic kidney diseases, CIEDI, positive methicillin-resistant Staphylococcus aureus nasal colonization, and statin use were 23%, 15.7%, 3.3%, 1.14%, 12.6%, and 56%, respectively. The logistic regression analysis showed that statins were significantly associated with a reduced risk of CIEDI; after controlling for other effects, the reduction was 66% (odds ratio 0.34 [0.2-0.59], P-value < 0.001). The effect of statins was confirmed by propensity score analysis. CONCLUSIONS: Our study showed that among patients receiving statins who had undergone CIED placement, there was a 66% reduction in subsequent CIEDI.
Authors: Yuebin Lin; Li Zhang; Ya Yang; Minhui Yang; Qingxiang Hong; Keming Chang; Juan Dai; Lu Chen; Changjiang Pan; Youdong Hu; Li Quan; Yanchun Wei; Sen Liu; Zhongmei Yang Journal: Stem Cells Int Date: 2021-05-03 Impact factor: 5.443
Authors: Boris N Tizenberg; Lisa A Brenner; Christopher A Lowry; Olaoluwa O Okusaga; David R Benavides; Andrew J Hoisington; Michael E Benros; John W Stiller; Ronald C Kessler; Teodor T Postolache Journal: Curr Psychiatry Rep Date: 2021-10-01 Impact factor: 5.285
Authors: Zachary A Yetmar; Supavit Chesdachai; Tarek Kashour; Muhammad Riaz; Danielle J Gerberi; Andrew D Badley; Elie F Berbari; Imad M Tleyjeh Journal: Open Forum Infect Dis Date: 2021-05-28 Impact factor: 3.835