Abstract
The aims of this study is to evaluate the association between angiotensin-converting enzyme inhibitor (ACE-I), angiotensin II receptor blocker (ARBs) and/or statin use with the risk of pneumonia, as well as and with in-hospital and short-term outpatient mortality in hospitalized older patients with pneumonia. Patients aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro Politerapuie SIMI–Società Italiana di Medicina Interna) register from 2010 to 2019 were screened to assess the diagnosis of pneumonia and classified on whether or not they were prescribed with at least one drug among ACE-I, ARBs, and/or statins. Further study outcomes were mortality during hospital stay and at 3 months after hospital discharge. Among 5717 cases included (of whom 18.0% with pneumonia), 2915 (51.0%) were prescribed at least one drug among ACE-I, ARBs, and statins. An inverse association was found between treatment with ACE-I or ARBs and pneumonia (OR = 0.79, 95% CI 0.65–0.95). A higher effect was found among patients treated with ACE-I or ARBs in combination with statins (OR = 0.67, 95% CI 0.52–0.85). This study confirmed in the real-world setting that these largely used medications may reduce the risk of pneumonia in older people, who chronically take them for cardiovascular conditions.
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The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
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Conceptualization, CF, IA, and RR. Methodology, IA. Formal analysis, SM. Writing—original draft preparation, CF, IA, and PMM. Writing—review and editing, CF, IA, RR, PMM, SM, AN, and FP. All authors have read and agreed to the published version of the manuscript.
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The participating centers had the approval from the local ethical committee and all patients provided signed informed consent. The authors declare that they have no competing financial interests.
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REPOSI collaborators are listed in the Supplementary appendix 1.
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Franchi, C., Rossio, R., Mandelli, S. et al. Statins, ACE/ARBs drug use, and risk of pneumonia in hospitalized older patients: a retrospective cohort study. Intern Emerg Med 19, 689–696 (2024). https://doi.org/10.1007/s11739-023-03528-w
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DOI: https://doi.org/10.1007/s11739-023-03528-w