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Statins and Abnormal Liver Enzymes

Anup Shrestha1,2, Alex Mulmi3,4, Raiko Munankarmi4

  • 1Internal Medicine Residency Program, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.

South Dakota Medicine : the Journal of the South Dakota State Medical Association
|March 9, 2019
PubMed

Insights

Statins effectively reduce mortality in cardiovascular diseases but can transiently elevate liver enzymes. This review guides physicians on safely using statins in patients with baseline or treatment-induced liver enzyme elevations.

Area of Science:

  • Cardiology
  • Hepatology
  • Pharmacology

Background:

  • Statins are crucial for managing ischemic heart disease, stroke, and peripheral vascular disease, significantly reducing mortality and morbidity.
  • Transient elevations in liver enzymes are a known side effect of statin therapy.
  • Physicians face challenges prescribing statins to patients with pre-existing or statin-induced liver enzyme abnormalities.

Purpose of the Study:

  • To review current literature and provide guidance on the safe and effective use of statins.
  • To address the clinical dilemma of statin prescription in patients with elevated liver enzymes.

Main Methods:

  • Literature review of existing studies and clinical guidelines.
  • Analysis of data regarding statin efficacy and safety in patients with liver enzyme alterations.

Main Results:

  • Statins are generally safe and effective even with mild liver enzyme elevations.
  • Premature cessation of statins due to transient enzyme increases can be detrimental.
  • Clear guidelines exist for monitoring and managing liver enzymes during statin therapy.

Conclusions:

  • Physicians should not prematurely discontinue statins solely based on transient liver enzyme elevations.
  • Careful patient selection and monitoring allow for the continued use of statins in most patients with elevated liver enzymes.
  • This review aims to support informed clinical decision-making regarding statin therapy.

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