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Statin therapy in patients with cirrhosis

Andrew P Wright1,2, Srinath Adusumalli1,2, Kathleen E Corey2,3

  • 1Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

Frontline Gastroenterology
|August 26, 2017
PubMed

Insights

Statins, used to lower cardiovascular risk, are safe and effective for patients with cirrhosis. Emerging data supports their use, addressing historical concerns about liver toxicity and altered pharmacokinetics in liver disease.

Area of Science:

  • Cardiology
  • Hepatology
  • Pharmacology

Background:

  • Cardiovascular disease (CVD) is a major cause of mortality in cirrhosis and post-liver transplantation.
  • Historically, statin use in liver disease was limited by concerns of hepatotoxicity and altered pharmacokinetics.
  • Emerging evidence challenges these prior concerns regarding statin safety and efficacy in liver disease.

Purpose of the Study:

  • To evaluate the safety and efficacy of statin therapy in patients with cirrhosis.
  • To address the historical underuse of statins in liver disease patients due to safety concerns.
  • To highlight the cardiovascular and pleiotropic benefits of statins in this population.

Main Methods:

  • Review of emerging data from randomized controlled trials (RCTs).
  • Analysis of observational studies investigating statin use in liver disease.
  • Assessment of pharmacokinetic alterations of statins in cirrhotic patients.

Main Results:

  • Randomized controlled trials and observational studies suggest statin therapy is safe in chronic liver disease and compensated cirrhosis.
  • Statin therapy demonstrates effectiveness in reducing cardiovascular events in patients with cirrhosis.
  • Emerging data indicates statins are well-tolerated, with manageable pharmacokinetic profiles in liver disease.

Conclusions:

  • Statin therapy is safe and effective for patients with cirrhosis, including those with compensated liver disease.
  • Cardiovascular risk reduction benefits of statins warrant their consideration in cirrhotic patients.
  • Potential pleiotropic benefits further support the use of statins in managing patients with liver disease and cardiovascular risk.

Keywords:
CARDIOVASCULAR DISEASEFATTY LIVERLIPIDS

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