Statin with standard antituberculosis regimen and mortality in hospitalized pulmonary tuberculosis

<b>Background:</b> Statin is found to be associated with reduced risk of tuberculosis (TB) infection, however, no study has shown the association between statin use and mortality in pulmonary TB with standard anti-TB treatment. <b>Methods:</b> We performed a retrospective cohort study to assess the relationship between statin use and mortality in hospitalized pulmonary TB patients with standard anti-TB regimen at Khon Kaen Hospital, Thailand from January 2013 to June 2018. Statin prescription was our exposure of interest categorized into five groups; 5, 10, 20, 40, and 80 simvastatin-equivalent dosage milligrams per day (mg/day). Our primary outcome was all-cause mortality rate within 90 days after admission. <b>Results:</b> A total of 3,003 pulmonary TB patients with the standard anti-TB regimen; 312 with statin exposure during admission and 2,691 without the exposure. Statin was associated with a reduced all-cause mortality rate as compared with no statin at 90 days from admission (adjusted hazard ratio [AHR], 0.576; 95% confidence interval [CI], 0.363 to 0.789; P=0.047). The mortality rate was lower among patients with statin 20 mg daily dose than among patients with other doses (AHR, 0.500; 95% CI, 0.236 to 0.764; P=0.018). However, it was not associated with sputum AFB conversion between 2 and 6 months after initiating the anti-TB treatment (AHR, 2.335; 95% CI, 0.713 to 7.773; P=0.160). <b>Conclusions:</b> In hospitalized patients with pulmonary TB, a statin with standard anti-TB regimen was significantly associated with a reduction of 90 days all-cause mortality after admission.