Effect of Common Medications on Longitudinal Pectoralis Muscle Area in Smokers.

Background: Cigarette smoke contributes to skeletal muscle wasting. While exercise and nutritional therapies are effective in improving skeletal muscle quantity and quality, the effect of medications on longitudinal muscle loss is unclear. We investigated whether long-term use of common medications affects longitudinal skeletal muscle changes in current and former smokers.

Methods: Using quantitative computed tomography (CT) imaging, we measured the 5-year changes in pectoralis muscle area (delta-PMA) and pectoralis muscle density (delta-PMD) of 4,191 participants in the Genetic Epidemiology of COPD (COPDGene) study. We tested whether specific medications were associated with delta-PMA and/or delta-PMD using regression analyses. Propensity score matching (PSM) analysis was performed to determine the effect of the medications on longitudinal changes on delta-PMA.

Results: Over the study period, the median delta-PMA for the entire population showed a decrease of 2.23 cm2 (IQR: -6.52, 1.54). Regression analyses demonstrated statin use was associated with less loss of PMA, whereas aspirin use was associated with a greater loss of PMA. Specifically in the PSM adjusted analysis, statin use was associated with attenuated loss of PMA (median; -1.5 vs -2.5 cm2, p=0.017), while aspirin use was associated with increased loss of PMA (median; -2.5 vs -1.9 cm2, p=0.040).

Conclusion: In current and former smokers, statin use was associated with reduced pectoralis muscle wasting, while aspirin use was associated with increased muscle loss. Additional research is needed to verify these findings.