High-intensity statins lower mortality risk in patients of chronic liver disease patients with ASCVD

South Korea: According to a recent study published in JAHA: Journal of American Heart Association, high-intensity statin treatment was associated with a lower mortality risk in patients with chronic liver disease (CLD) and atherosclerotic cardiovascular disease.

The study aimed to assess the association between statin intensity and mortality in patients with chronic liver disease and atherosclerotic cardiovascular disease.

The study was a population-based cohort study in South Korea that assessed the risk of survival and clinical outcomes using inverse probability of treatment-weighted Cox proportional hazards regression.

The study involved 10,442 patients with CLD and atherosclerotic cardiovascular disease and an average follow-up period of 2.35 years. Among these patients, 52.8% received high-intensity statins, while 47.2% received low/moderate-intensity statins.

The study revealed the following clinical findings:

1. High-intensity statin was associated with a lower risk for all-cause mortality compared to low/moderate-intensity statin.

2. High-intensity statin was associated with a lower risk for cardiovascular-cause mortality compared to low/moderate-intensity statin.

3. High-intensity statin was associated with a lower risk for liver-cause mortality compared to low/moderate-intensity statin.

4. Hospitalizations for recurrent myocardial infarction and stroke increased among high-intensity statin users.

5. The effect estimate was homogeneous in the absolute scale for both myocardial infarction and stroke, despite an increased risk of hospitalization.

The study's authors conclude that “High-intensity statin use is associated with a lower risk of mortality in patients with CLD and atherosclerotic cardiovascular disease. These findings support the current guidelines for statin use in CLD patients and demonstrate the potential benefits of optimal-intensity statin treatment. While high-intensity statin use may increase the risk of hospitalization for recurrent myocardial infarction and stroke, the overall benefits of treatment outweigh the potential risks.”

The study provided evidence for the use of high-intensity statin treatment in patients with CLD and atherosclerotic cardiovascular disease for secondary prevention. These findings may have significant implications for clinical practice and inform future research in this area.

Reference:

Bea S., Sun-Oh I., Hwan Kim J., Hyun Sinn D., Chang Y., Ryu S., Shin J.; High‐Intensity Statin Reduces the Risk of Mortality Among Chronic Liver Disease Patients With Atherosclerotic Cardiovascular Disease: A Population‐Based Cohort Study; Journal of the American Heart Association. 2023;12:e028310; doi: https://doi.org/10.1161/JAHA.122.028310