Effects of non-HDL-C and statin therapy on mortality in ARDS: a retrospective cohort study.

Background: Acute respiratory distress syndrome (ARDS) is a critical and potentially fatal condition marked by inflammation and coagulation disorders. Statins, a class of cholesterol-lowering medications, have been explored for potential anti-inflammatory properties, yet their exact role in ARDS remains unclear. Methods: Patients diagnosed with ARDS were sourced from the MIMIC-IV database (version 3.0). To balance baseline characteristics, propensity score matching (PSM) was applied. Short-term mortality was evaluated using Kaplan-Meier survival analysis. Factors associated with short-term mortality were determined using both univariate and multivariate Cox regression analyses. The potential impact of unmeasured confounding was assessed using the E-value. Additionally, subgroup analyses were performed to investigate heterogeneity and evaluate the robustness of the findings. Results: The study included 10,368 ARDS patients, of whom 5,184 received statin therapy and 5,184 did not. Kaplan-Meier analysis revealed significantly lower short-term mortality in the statin-treated group. Both univariate (HR, 0.48; 95% CI, 0.41-0.58; Conclusion: Statin therapy appears to confer significant clinical benefits in ARDS patients, particularly in those with high non-HDL-C levels. These findings indicate that non-HDL-C might be a useful marker for identifying ARDS patients who may benefit most from statin therapy.