Statins and Delirium: Is There a Role?

Current Atherosclerosis Reports

Volumn 17, Issue 1, 2015, Pages

  Taburyanskaya, Margarita ^a   Hassig, Tanna ^a  

^a MEDICAL UNIVERSITY OF SOUTH CAROLINA   (United States)

Author keywords

Critical care; Delirium; HMG CoA reductase inhibitors; Postoperative; Prevention; Statins

Indexed keywords

HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR;

CRITICALLY ILL PATIENT; DELIRIUM; DRUG EFFICACY; DRUG USE; HUMAN; PATIENT ASSESSMENT; POSTOPERATIVE CARE; PRACTICE GUIDELINE; PROPHYLAXIS; REVIEW; SEDATION; STUDY DESIGN; CRITICAL ILLNESS; PROGNOSIS; RISK FACTOR;

CRITICAL ILLNESS; DELIRIUM; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; PROGNOSIS; RISK FACTORS;

EID: 84938350002     PISSN: 15233804     EISSN: 15346242     Source Type: Journal    
DOI: 10.1007/s11883-014-0470-9     Document Type: Review

References (44)

1. Leslie D, Inouye S. The importance of delirium: economic and societal costs. J Am Geriatr Soc. 2011;N59 Suppl 2:S241–3.
2. Brummel N, Jackson J, Pandharipande P, et al. Delirium in the ICU and subsequent long-term disability among survivors of mechanical ventilation. Crit Care Med. 2014;42:369–77.
3. Shehabi Y, Chan L, Kadiman S, et al. Sedation depth and long-term mortality in mechanically ventilated critically ill adults: a prospective longitudinal multicenter cohort study. Intensive Care Med. 2013;39:910–8.
4. Ouimet S, Kavanagh B, Gottfried S. Incidence, risk factors and consequences of ICU delirium. Intensive Care Med. 2007;33:66–73.
5. Siddiqi N, House A, Holmes J. Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing. 2006;35:350–64.
6. Pandharipande P, Jackson J, Ely E. Delirium: acute cognitive dysfunction in the critically ill. Curr Opin Crit Care. 2005;11:360–8.
7. Pandharipande P, Girard T, Jackson J. Long-term cognitive impairment after critical illness. N Engl J Med. 2013;369(14):1306–16.
8. Markar S, Smith I, Karthikesalingam A, et al. The clinical and economic costs of delirium after surgical resection for esophageal malignancy. Ann Surg. 2013;258:77–81.
9. Reade M, Finfer S. Sedation and delirium in the intensive care unit. N Engl J Med. 2014;370:444–54.
10. Maldonado J. Neuropathogenesis of delirium: review of current etiologic theories and common pathways. Am J Geriatr Psychiatry. 2013;21:1190–222. This article provides excellent review on delirium pathophysiology explaining the basis of neuroinflammatory hypothesis, which is the reason why statins are used for delirium prevention.
11. Ebersoldt M, Sharshar T, Annane D. Sepsis-associated delirium. Intensive Care Med. 2007;33(6):941–50.
12. Semmler A, Hermann S, Mormann F, et al. Sepsis causes neuroinflammation and concomitant decrease of cerebral metabolism. J Neuroinflammation. 2008;5:38.
13. Morandi A, Hughes C, Girard T, et al. Statins and brain dysfunction: a hypothesis to reduce the burden of cognitive impairment in patients who are critically ill. Chest. 2011;140(3):580–5.
14. Cerejeira J, Firmino H, Vaz-Serra A, et al. The neuroinflammatory hypothesis of delirium. Acta Neuropathol. 2010;119(6):737–54.
15. Perry V, Nicoll J, Holmes C. Microglia in neurodegenerative disease. Nat Rev Neurol. 2010;6(4):193–201.
16. Ando H, Takamura T, Ota T, et al. Cerivastatin improves survival of mice with lipopolysaccharide-induced sepsis. J Pharmacol Exp Ther. 2000;294(3):1043–6.
17. Diomede L, Albani D, Sottocorno M, et al. In vivo anti-inflammatory effect of statins is mediated by nonsterol mevalonate products. Arterioscler Thromb Vasc Biol. 2001;21:1327–32.
18. Terblanche M, Almog Y, Rosenson R, et al. Statins and sepsis: multiple modifications at multiple levels. Lancet Infect Dis. 2007;7:358–68.
19. Xinwei J, Xianghua F, Jing Z, et al. Comparison of usefulness of simvastatin 20 mg versus 80 mg in preventing contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Am J Cardiol. 2009;104:519–24.
20. Huffmyer J, Mauermann W, Thiele R, et al. Preoperative statin administration is associated with lower mortality and decreased need for postoperative hemodialysis in patients undergoing coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth. 2009;23:468–73.
21. Welten G, Chonchol M, Schouten O, et al. Statin use is associated with early recovery of kidney injury after vascular surgery and improved long-term outcome. Nephrol Dial Transplant. 2008;23:3867–73.
22. Craig T, Duffy M, Shyamsundar M, et al. A randomized clinical trial of hydroxymethylglutaryl–coenzyme A reductase inhibition for acute lung injury (The HARP Study). Am J Respir Crit Care Med. 2011;183(5):620–6.
23. Page V, Davis D, Zhao X, et al. Statin use and risk of delirium in the critically ill. Am J Respir Crit Care Med. 2014;189(6):666–73. A clinical trial that supports statins’ use for delirium prevention in critically ill patients and demonstrated that reduction of delirium incidence is associated with statin therapy.
24. Morandi A, Hughes C, Thompson J, et al. Statins and delirium during critical illness: a multicenter, prospective cohort study. Crit Care Med. 2014;42:1899–909. A clinical trial that supports statins use for delirium prevention in critically ill patients and demonstrated the reduction of delirium incidence when statin therapy is initiated in septic patients early in the course of the disease or when the statin therapy is given to patients without sepsis diagnosis later in the course of hospital stay.
25. Redelmeier D, Thiruchelvam D, Daneman N. Delirium after elective surgery among elderly patients taking statins. CMAJ. 2008;179(7):645–52. An epidemiologic study that showed that postoperative statin administration was associated with higher incidence of delirium which was alleviated in patients on non-lipophilic statin therapy.
26. Levy A, O’Brien B, Sellors C, et al. Coding accuracy of administrative drug claims in the Ontario Drug Benefit database. Can J Clin Pharmacol. 2003;10:67–71.
27. Cruz J, Tomasi C, Alves S, et al. The incidence of delirium in patients pretreated with statins who remain in an intensive care unit after cardiac surgery. Rev Bras Ter Intensiva. 2012;24(1):52–7. This study demonstrated that statin therapy was not associated with prevention or increased incidence of delirium when administered after surgery.
28. Mariscalco G, Cottini M, Zanobini M, et al. Preoperative statin therapy is not associated with a decrease in the incidence of delirium after cardiac operations. Ann Thorac Surg. 2012;93(5):1439–47. This study demonstrated that statin therapy was not associated with prevention or increased incidence of delirium when administered after surgery.
29. Katznelson R, Djaiani G, Borger M, et al. Preoperative use of statins is associated with reduced early delirium rates after cardiac surgery. Anesthesiology. 2009;110(1):67–73. This study demonstrated that statin therapy was associated with protective effects when administered after surgery, especially in elderly patients.
30. Marcantonio E. Statins and postoperative delirium. CMAJ. 2008;179(7):627–8.
31. Barr J, Fraser G, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41(1):263–306. Pain, agitation, and delirium guidelines that outline recommendation and provide clinical evidence supporting non-pharmacological methods, that are implemented by the ICU multidisciplinary team, over pharmacological approach for delirium prevention and management.
32. Laufs U, Endres M, Custodis F, et al. Suppression of endothelial nitric oxide production after withdrawal of statin treatment is mediated by negative feedback regulation of rho GTP-ase gene transcription. Circulation. 2000;102(25):3104–10.
33. Vecchione C, Brandes R. Withdrawal of 3-hydroxy-3- methylglutaryl coenzyme A reductase inhibitors elicits oxidative stress and induces endothelial dysfunction in mice. Circ Res. 2002;91(2):173–9.
34. Sposito A, Carvalho L, Cintra R, Brasilia Heart Study Group, et al. Rebound inflammatory response during the acute phase of myocardial infarction after simvastatin withdrawal. Atherosclerosis. 2009;207(1):191–4.
35. Sirtori C. The pharmacology of statins. Pharmacol Res. 2014. doi:10.1016/j.phrs.2014.03.002.
36. Schachter M. Chemical, pharmacokinetic, and pharmacodynamic properties of statins: an update. Fundam Clin Pharmacol. 2005;19(1):117–25.
37. Stone N, Robinson J, Lichtenstein A, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S1–S45.
38. Albayda J, Mammen A. Is statin-induced myositis part of the polymyositis disease spectrum? Curr Rheumatol Rep. 2014;16(8):433.
39. Drobny M, Pullmann R, Odalos I. Incidence of skeletal muscle disorders after statins’ treatment: consequences in clinical and EMG picture. Neuro Endocrinol Lett. 2014;35(2):123–8.
40. Perdices E, Medina-Cáliz I, Hernando S, et al. Hepatotoxicity associated with statin use: analysis of the cases included in the Spanish Hepatotoxicity Registry. Rev Esp Enferm Dig. 2014;106(4):246–54.
41. Russo M, Hoofnagle J, Gu J, et al. Spectrum of statin hepatotoxicity: experience of the drug-induced liver injury network. Hepatology. 2014;60:679–86.
42. Hunter A, Johnson L, Coustasse A. Reduction of intensive care unit length of stay: the case of early mobilization. Health Care Manag (Frederick). 2014;33(2):128–35.
43. Patel J, Baldwin J, Bunting P, Laha S. The effect of a multicomponent multidisciplinary bundle of interventions on sleep and delirium in medical and surgical intensive care patients. Anaesthesia. 2014;69(6):540–9.
44. Javedan H, Tulebaev S. Management of common postoperative complications delirium. Clin Geriatr Med. 2014;30(2):271–8.