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Hypercholesterolemia & Statin Exposure in Cirrhosis

Gastroenterology; ePub 2019 Jan 18; Kaplan, et al

In a large cohort of patients with cirrhosis, hypercholesterolemia was associated with well-preserved hepatic function and reduced mortality. However, each cumulative year of statin exposure was associated with an independent 8.0% to 8.7% reduction of mortality of patients with cirrhosis of Child-Turcotte-Pugh classes A and B. Researchers performed a retrospective cohort study of patients with newly diagnosed cirrhosis in the Veterans Health administration. Participants were divided into 2 cohorts: 21,921 patients with prior statin exposure (existing users) and 51,023 statin-naïve individuals, of whom 8,794 subsequently initiated statin therapy (new initiators) and 44,269 did not (non-initiators). Among the findings:

  • In statin-naïve subjects, every 10 mg/dL increase in baseline total cholesterol was associated with a 3.6% reduction in mortality.
  • Among existing users, each year of continued statin exposure was associated with a hazard ratio (HR) of 0.920 for mortality.
  • Each year of statin exposure among new initiators was associated with a HR of 0.913 for mortality, after risk-set matching.


Kaplan DE, Serper M, Mehta R, et al. Effects of hypercholesterolemia and statin exposure on survival in a large national cohort of patients with cirrhosis. [Published online ahead of print January 18, 2019]. Gastroenterology. doi:10.1053/j.gastro.2019.01.026.