Respiratory failure & ventilation
Effect of total cholesterol and statin therapy on mortality in acute respiratory distress syndrome (ARDS) patients: a secondary analysis of the SAILS and HARP-2 trials
Authors' conclusion
Cholesterol levels are low in two cohorts with sepsis-related ARDS, and those in the lowest cholesterol quartile are sicker. Despite the very low levels of cholesterol, simvastatin therapy seems safe and may reduce mortality in this group, though rosuvastatin was associated with harm.
Study context
- Population
- Patients with ARDS and sepsis from two multicentre trials (SAILS, HARP-2)678 SAILS, 509 HARP-2
- Comparison
- Statin vs placebo in lowest cholesterol quartile vs all other quartiles
- Primary endpoint
- Mortality and medication effect
- Follow-up
- 60 days
Methodological detailsmulticentre, subgroup analysis by cholesterol quartile
- Multicentre
- Subgroup analysis by cholesterol quartile
Primary result
As reported in the abstract
60-day mortality with statin in low cholesterol subgroup
Odds ratio (95% CI)P value
Rosuvastatin (SAILS, low cholesterol) vs Placebointeraction p = 0.02
2.23(1.06–4.77)
P = 0.02Simvastatin (HARP-2, low cholesterol) vs Placebointeraction p = 0.22
0.44(0.17–1.07)
P = 0.06Further findings
Cholesterol at enrolment
- Median cholesterol in both SAILS and HARP-2 (mg/dL)
- 97
Illness severity with low cholesterol
- Low cholesterol associated with higher APACHE III and shock prevalence (SAILS), higher SOFA and vasopressor use (HARP-2)
Original publication
Effect of total cholesterol and statin therapy on mortality in ARDS patients: a secondary analysis of the SAILS and HARP-2 trials. Crit Care. Published 28 March 2023. doi:10.
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