Statins tied to reduced mortality in compensated liver disease

  • Unger LW & al.
  • Sci Rep
  • 12 Aug 2019

  • International Clinical Digest
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Takeaway

  • Though underused, guideline-indicated statins are associated with reduced mortality in patients with nonadvanced chronic liver disease (non-ACLD).

Why this matters

  • Guidelines do not discriminate based on presence/absence of ACLD.
  • Statins should be avoided only in patients with decompensated cirrhosis and statin-induced liver injury, according to a recent expert review.

Study design

  • Austrian study, 1265 patients with CLD; 58.3% had non-ACLD (liver stiffness
  • Mortality was determined using the national death registry.
  • Funding: None.

Key results

  • Indicated statins were used in 14.1% of patients; 9.6% received no statins despite indication, and 76.3% had no statin indication.
  • Statin underuse rates were 34.2% in non-ACLD and 48.2% in ACLD.
  • In non-ACLD, nonreceipt of an indicated statin was tied to poorer survival (Plog-rank=.018).
  • 1-, 2-, 3-, and 4-year survival rates for non-ACLD, respectively:
    • No statin despite indication: 96.4%, 92.7%, 89.9%, and 89.9%;
    • On statin: 99.1%, 99.1%, 97.0%, and 97.0%; and
    • No statin indication: 98.4%, 97.9%, 97.7%, and 97.3%.
  • Multivariate analysis confirmed that use vs nonuse of indicated statins was tied to improved survival in non-ACLD: HR, 0.225 (P=.044).
    • Effect on liver-related mortality failed to reach significance (HR, 0.088; P=.068).
  • In ACLD, statin use had no significant effect on survival (Plog-rank=.264).

Limitations

  • Retrospective design.
  • Statin intake/adherence not captured.

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