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BioMed Research International
Volume 2017 (2017), Article ID 5642704, 8 pages
https://doi.org/10.1155/2017/5642704
Clinical Study

Effect of Prior Atorvastatin Treatment on the Frequency of Hospital Acquired Pneumonia and Evolution of Biomarkers in Patients with Acute Ischemic Stroke: A Multicenter Prospective Study

1Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
2Department of Emergency, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
3Department of Emergency, Minhang District Central Hospital, Shanghai 201100, China

Correspondence should be addressed to Chunyan Liu; moc.anis@yclrotcod and Yuan Gao; moc.anis@neruhznauyoag

Received 12 July 2016; Revised 23 December 2016; Accepted 4 January 2017; Published 5 March 2017

Academic Editor: Fabrizio Montecucco

Copyright © 2017 Yuetian Yu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To investigate whether prior treatment of atorvastatin reduces the frequency of hospital acquired pneumonia (HAP). Methods. Totally, 492 patients with acute ischemic stroke and Glasgow Coma Scale ≤ 8 were enrolled in this study. Subjects were assigned to prior atorvastatin treatment group (, PG) and no prior treatment group (, NG). All the patients were given 20 mg atorvastatin every night during their hospital stay. HAP frequency and 28-day mortality were measured. Levels of inflammatory biomarkers [white blood cell (WBC), procalcitonin (PCT), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6)] were tested. Results. There was no significant difference in the incidence of HAP between PG and NG (25.74% versus. 24.55%, ) and 28-day mortality (50.72% versus 58.18%, ). However, prior statin treatment did modify the mortality of ventilator associated pneumonia (VAP) (36.54% versus 58.14%, ) and proved to be a protective factor (HR, 0.564; 95% CI, 0.310~0.825, ). Concentrations of TNF-α and IL-6 in PG VAP cases were lower than those in NG VAP cases (). Conclusions. Prior atorvastatin treatment in patients with ischemic stroke was associated with a lower concentration of IL-6 and TNF-α and improved the outcome of VAP. This clinical study has been registered with ChiCTR-ROC-17010633 in Chinese Clinical Trial Registry.