Statins and gastroduodenal endoscopic lesions: A case-control study

Area of Science:

• Gastroenterology and Pharmacology
• Cardiovascular Medicine

Background:

• Non-steroidal anti-inflammatory drugs (NSAIDs) are a common cause of gastrointestinal lesions.
• Statins, primarily used for cholesterol management, have shown potential gastroprotective effects in experimental studies.
• Understanding the clinical impact of statins on NSAID-induced gastrointestinal damage is crucial for patient care.

Purpose of the Study:

• To investigate the influence of chronic statin therapy on the occurrence of endoscopic gastrointestinal lesions.
• To evaluate the protective role of statins against peptic ulcer disease and its complications in a clinical setting.
• To identify risk factors for gastrointestinal lesions and assess the impact of statins in mitigating these risks.

Main Methods:

• A consecutive series of 564 patients undergoing upper digestive endoscopy were recruited.
• Patients were stratified into a study group (n=220) receiving chronic statin therapy (≥6 months) and a control group (n=344) without statins.
• Data were analyzed correlating statin use with factors like age, Helicobacter pylori infection, smoking, alcohol consumption, ulcer history, gastrotoxic drug use (including low-dose aspirin [ASA]), and comorbidities.

Main Results:

• Chronic statin therapy was associated with a significant protective effect against mild/severe endoscopic lesions (OR=0.31, P<.01).
• The risk of developing lesions with ASA intake decreased significantly when statin therapy was present (from 6.26 to 3.40, P<.01).
• Patients without statins and with cardiovascular conditions (ischemic coronary artery disease, heart failure, systemic atherosclerosis) had a significantly increased risk of lesions compared to the statin group.

Conclusions:

• Chronic statin therapy plays a protective role against endoscopic gastrointestinal lesions.
• This protective effect is particularly evident in patients consuming low-dose aspirin (ASA) and those with underlying cardiovascular diseases.
• Statins may represent a valuable therapeutic strategy for preventing NSAID-induced gastropathy in high-risk individuals.