Use of statins in patients with liver disease

Sweta Tandra, Raj Vuppalanchi

Research output: Contribution to journalReview article

37 Citations (Scopus)

Abstract

Cardiovascular disease is as common in individuals with chronic liver disease as in the general population. Moreover, recent data suggest that patients with nonalcoholic fatty liver disease (NAFLD) may have a cardiovascular risk greater than that conferred by the conventional risk factors. There is unequivocal evidence that cardiovascular disease is an important cause of morbidity and mortality in this patient population and thus requires consideration of aggressive therapy with lipid-lowering agents such as statins. Because all statins are hepatically cleared and can cause elevations in liver biochemistries, there is a concern that patients with underlying liver disease may be at increased risk for hepatotoxicity. However, recent data, along with an assessment of statin safety by the Liver Expert Panel, suggest that statins are generally well tolerated in patients with chronic liver disease such as NAFLD, primary biliary cirrhosis, and hepatitis C virus. These drugs also appear to be safe in patients with stable/compensated cirrhosis. However, decompensated cirrhosis and acute liver failure should be considered contraindications for lipid-lowering therapy as these patients are unlikely to benefit because of their generally grave prognosis. Although routine hepatic biochemical test monitoring is recommended, the cost-effectiveness of this approach has been questioned. The benefit of statins in patients with underlying liver disease who are otherwise important candidates for statin therapy far outweighs the risk of a very rare event of serious liver injury.

Original languageEnglish (US)
Pages (from-to)272-278
Number of pages7
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume11
Issue number4
DOIs
StatePublished - Jan 1 2009

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Liver Diseases
Liver
Fibrosis
Chronic Disease
Cardiovascular Diseases
Lipids
Acute Liver Failure
Biliary Liver Cirrhosis
Hepacivirus
Biochemistry
Population
Cost-Benefit Analysis
Therapeutics
Morbidity
Safety
Mortality
Wounds and Injuries
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Use of statins in patients with liver disease. / Tandra, Sweta; Vuppalanchi, Raj.

In: Current Treatment Options in Cardiovascular Medicine, Vol. 11, No. 4, 01.01.2009, p. 272-278.

Research output: Contribution to journalReview article

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