Effects of statins on anxiety and depression in patients with asthma-chronic obstructive pulmonary disease overlap syndrome

Abstract

Background: The effects of statins on anxiety and depression in patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) have not been reported. This population-based study investigated these effects.

Methods: Taiwan's National Health Insurance Research Database between 2000 and 2010. We enrolled two ACOS cohorts, one of statin users (n = 1252) and one of nonstatin users matched by age, sex, and index date (n = 7887). The cumulative incidence of anxiety and depression was analyzed using time-dependent Cox proportional regression analysis.

Results: After adjustment for multiple confounding factors, including age, sex, comorbidities, and medications-statins, inhaled corticosteroids (ICSs), and oral steroids (OSs)-the ACOS cohort with statin use had significantly lower risks of anxiety and depression (anxiety: adjusted hazard ratio [aHR] = 0.34, 95% confidence interval [CI] = 0.28-0.42; depression: aHR = 0.36, 95% CI = 0.25-0.53). The aHRs (95% CIs) for statin use with ICSs or OSs were 0.32 (0.13-0.78) and 0.37 (0.24-0.57), respectively.

Conclusion: The ACOS cohort with statin use had lower risks of anxiety and depression, regardless of age, sex, commodities, or ICSs and OSs. The incidences of anxiety and depression were relatively low among users of statins with ICSs or OSs in the ACOS cohort.

Keywords: Asthma–chronic obstructive pulmonary disease overlap syndrome (ACOS); CI, confidence interval; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification; ICS, inhaled corticosteroid; List of abbreviations: ACOS, asthma-chronic obstructive pulmonary disease overlap syndrome; OS, oral steroid; Oral steroids (OSs); Statin; aHR, adjusted hazard ratio; inhaled corticosteroids (ICSs).