AB 2. Impact of statins and ace inhibitors use on length of hospital stay in patients with community acquired pneumonia

Background Statins and angiotensin-converting enzyme (ACE) inhibitors are widely used in the treatment of cardiovascular diseases and arterial hypertension respectively, and several studies in experimental and animal models suggest their anti-inflammatory and immunomodulatory effect. However, we are lacking big trials that prove the potential benefit on clinical outcome and reduced hospital stay in community acquired pneumonia (CAP) patients. Aim of the study was to determine whether the use of statins and ACE inhibitors reduces the length of hospitalization in patients with CAP. Patients and methods Patients admitted in our clinic with CAP (n=154; 91 males, 63 females) were retrospectively studied. Out of them, 60 (39%) were receiving statins, 53 (34.4%) ACE inhibitors and 23 (14.9%) both medications. The severity of pneumonia was assessed, on admittance, by Pneumonia Severity Index (PSI). Results Length of stay (LOS) did not differ significantly between groups. More specifically, in statins users, LOS was 9±5.1 days, in ACE inhibitors users 8.5±4.2 days, in patients who were treated with both medications 7.7±4 days, while in those receiving no medication was 7.8±4.1 days (P=0.198). A separate analysis of COPD patients showed that LOS was significantly longer in comparison to non-COPD patients (9.5±5.3 vs. 7.4±3.7 days; P=0.047), but in this subgroup, medication use did not affect LOS (statins users 11.3±5.2 days, ACE inhibitors users 10.6±6 days, both drug users 15±5.7 days, no medication 10.5±5; P=0.328). Conclusions Length of hospital stay due to CAP is longer in COPD patients and it is not affected by chronic use of medication with immunomodulatory properties like statins or ACE inhibitors.