Statins did not reduce exacerbation rate in COPD with cardiovascular comorbidities (data from COSYCONET)

S Fähndrich; N Frantzi; R Jörres; P Alter; C Herr; S Söhler; H Kauczor; H Watz; B Waschki; C Vogelmeier; F Trudzinski; A Omlor; F Seiler; F Trudzinski; F Biertz; D Stolz; F Trinkmann; D Soriano; I Moneke; M Eichenlaub; K Kahnert; X Nguyen; J Michels-Zetsche; G Rohde; R Bals

doi:10.1055/s-0045-1804575

Pneumologie, Inhaltsverzeichnis

Pneumologie 2025; 79(S 01): S19
DOI: 10.1055/s-0045-1804575

Abstracts

A2 – COPD

Statins did not reduce exacerbation rate in COPD with cardiovascular comorbidities (data from COSYCONET)

Authors

S Fähndrich

¹Klinik für Klinik für Pneumologie des Universitätsklinikums Freiburg; Abteilung Pneumologie, Universitätsklinik Freiburg; Klinik für Pneumologie
N Frantzi

²Universitätsklinikum Freiburg; Klinik für Pneumologie
R Jörres

³Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin; Klinikum der Universität München; LMU München
P Alter

⁴Universitätsklinikum Gießen U. Marburg, Standort Marburg; Innere Medizin; Sp Pneumologie
C Herr

⁵Universitätsklinikum des Saarlandes; Innere Medizin V, AG Bals; Pneumologie, Allergologie, Beatmungsmedizin
S Söhler

⁶Philipps-Universität Marburg (Umr); Uniklinikum Marburg, Baldingerstraße 35043 Marburg; Kompetenznetz Asthma und Copd
H Kauczor

⁷Klinik für Diagnostische und Interventionelle Radiologie; Universitätsklinikum Heidelberg
H Watz

⁸Velocity Clinical Research Ahrensburg; Lungenclinic Grosshansdorf, Airway Research Center North (Arcn), Deutsches Zentrum für Lungenforschung (Dzl)
B Waschki

⁹Klinikum Itzehoe; Klinik für Pneumologie, Infektiologie und Onkologie
C Vogelmeier

¹⁰Innere Medizin; Sp Pneumologie
F Trudzinski

¹¹Innere Medizin V –pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Universitätskliniken des Saarlandes, Homburg.; Thoraxklinik Universitätsklinikum Heidelberg
A Omlor

¹²Universitätsklinikum des Saarlandes, Klinik für Innere Medizin V – Pneumologie, Allergologie, Intensivmedizin, Homburg, Germany; Universitätsklinikum des Saarlandes
F Seiler

¹³Klinik für Innere Medizin V – Pneumologie, Allergologie, Intensivmedizin; Universitätsklinikum des Saarlandes
F Trudzinski

¹⁴Thoraxklinik Heidelberg; Thoraxklinik Heidelberg; Pneumologie und Beatmungsmedizin
F Biertz

¹⁵Medizinische Hochschule Hannover; Institut für Biometrie
D Stolz

¹⁶Universitätsklinikum Freiburg; Klinik für Pneumologie, Department Innere Medizin, Medizinische Fakultät, Albert Ludwigs Universität, Freiburg, Deutschland; Clinic of Respiratory Medicine and Pulmonary Cell Research
F Trinkmann

¹⁷Thoraxklinik Heidelberg gGmbH; Thoraxklinik Universitätsklinikum Heidelberg; Thoraxklinik Heidelberg gGmbH
D Soriano

¹⁸Klinik für Pneumologie, Universitätsklinik Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Deutschland; Universitätsklinikum Freiburg; Klinik für Pneumologie
I Moneke

¹⁹Universitätsklinik Freiburg; Klinik für Thoraxchirurgie; Thoraxchirurgie
M Eichenlaub

²⁰Universitätsklinikum Freiburg, Klinik für Kardiologie und Angiologie; Universitätsklinikum Freiburg, Klinik für Pneumologie
K Kahnert

²¹Medicenter Germering; Pneumologie
X Nguyen

²²Department of Pneumology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.; University Freiburg, Medical Center
J Michels-Zetsche

²³Universitätsklinikum Heidelberg; Thoraxklinik; Pneumologie und Beatmungsmedizin
G Rohde

²⁴Universitätsklinikum Frankfurt; Medizinische Klinik 1; Schwerpunkt Pneumologie/Allergologie
R Bals

²⁵Direktor der Klinik für Innere Medizin V; Universitätsklinikum des Saarlandes, Gebäude 91; Innere Medizin V

Abstract

Volltext

Background: The effects of statins on exacerbation risk in COPD remains unclear. Previous studies often excluded patients with cardiovascular comorbidities despite their high prevalence in COPD and role for exacerbations. Based on the cardioprotective properties of statins, we hypothesised that statins may reduce the risk of exacerbations especially in patients with cardiovascular comorbidities.

Methods: 1887 patients of the German COPD cohort COSYCONET (COPD and Systemic Consequences Comorbidities Network) of GOLD grades 1-4 (37.8% female, mean age 64.78±8.3) were examined at baseline and over a period of 4.5 years for the occurrence of at least one exacerbation or severe exacerbation per year in cross-sectional and longitudinal analyses adjusted for age, gender, BMI, GOLD grade and pack-years. Due to their collinearity, various cardiovascular diseases were tested in separate analyses, whereby the potential effect of statins in the presence of a specific comorbidity was tested as interaction between statins and comorbidity. We also identified patients who never took statins, always took statins, or initiated statin intake during the follow-up.

Results: 1306 patients never took statins, 31.6% were statin user, and 12.9% initiated statins during the follow-up. Most cardiovascular diseases were significantly (p<0.05)may associated with an increased risk of COPD exacerbations, but in none of them the intake of statins was a significant attenuating factor, neither overall nor in modulating the increased risk linked to the specific comorbidities. The results of the cross-sectional and longitudinal analyses were consistent with each other, also those regarding at least 1 exacerbation or at least 1 severe exacerbation per year.

Conclusion: These findings complement the existing literature and may suggest that even in patients with COPD, cardiovascular comorbidities and a statin therapy that targets these comorbidities, the effects of statins on exacerbation risk are either negligible or more subtle than a reduction in exacerbation frequency