Statin use is not associated with liver related mortality
Background and Aim. Statins are commonly used medications for the treatment of dyslipidemia. Although there are reported cases of hepatotoxicity related to statins, very few are associated with severe course and liver failure.Material and methods. We used the Third National Health and Nutrition Exam...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2014-01-01
|
| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119309081 |
| _version_ | 1823969073851006976 |
|---|---|
| author | Zahra Younoszai Li Zheng Maria Stepanova Madeline Erario Rebecca Cable Zobair M. Younossi |
| author_facet | Zahra Younoszai Li Zheng Maria Stepanova Madeline Erario Rebecca Cable Zobair M. Younossi |
| author_sort | Zahra Younoszai |
| collection | DOAJ |
| description | Background and Aim. Statins are commonly used medications for the treatment of dyslipidemia. Although there are reported cases of hepatotoxicity related to statins, very few are associated with severe course and liver failure.Material and methods. We used the Third National Health and Nutrition Examination Survey (NHANES III)-mortality linked files to assess the association between statin use and liver-related mortality. Patients with established causes of liver disease (HCV RNA-positive, HBs-Ag-positive, NAFLD by hepatic ultrasound, iron overload and excessive alcohol use of > 20 g of alcohol per day with elevated liver enzymes) were excluded.Results. Of all adult NHANES III participants enrolled in 1988-1994 (n = 20,050), 9,207 individuals had sufficient demographic, clinical and medical information making them eligible for this study (age 41.26 ± 0.38, 46.76% male, 76.67% Caucasian, BMI 26.39 ± 0.38, 16.99% had diabetes or insulin resistance, 16.97% had hypertension, 65.28% had dyslipdemia). Of the entire study cohort, 90 (1.25%) participants reported using statins at the time of the interview. Median mortality follow-up for the study cohort was 175.54 months. During this period, 1,330 individuals (11.25%) died with 26 (0.17%) being liver-related deaths. For the cohort using statins, there were 37 deaths (40.15%) after a median follow-up of 143.35 months. In fact, the top cause of death for statin users was cardiac related (16 cases, 33.62%). However, after adjusting for major demographic, clinical and metabolic confounders, statin use was not associated with cardiovascular deaths in males (Hazard Ratio, 0.79, 95% Confidence Interval, 0.30-2.13), but was associated with higher risk of cardiovascular deaths in females (odds ratio, 2.32, 95% confidence interval, 1.58-3.40). Furthermore, the rate of liver-related mortality was significantly lower (p = 0.0035) among statin users compared to non-statin users.Conclusions. After a decade of follow up, there was no association between statin use and liver-related mortality. |
| first_indexed | 2024-12-17T18:51:43Z |
| format | Article |
| id | doaj.art-973278a8630149b59fe4916c36414270 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-17T18:51:43Z |
| publishDate | 2014-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-973278a8630149b59fe4916c364142702022-12-21T21:36:33ZengElsevierAnnals of Hepatology1665-26812014-01-011318490Statin use is not associated with liver related mortalityZahra Younoszai0Li Zheng1Maria Stepanova2Madeline Erario3Rebecca Cable4Zobair M. Younossi5Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Correspondence and reprint request:Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United StatesBetty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United StatesCenter for Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United StatesCenter for Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United StatesCenter for Liver Disease, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United StatesBackground and Aim. Statins are commonly used medications for the treatment of dyslipidemia. Although there are reported cases of hepatotoxicity related to statins, very few are associated with severe course and liver failure.Material and methods. We used the Third National Health and Nutrition Examination Survey (NHANES III)-mortality linked files to assess the association between statin use and liver-related mortality. Patients with established causes of liver disease (HCV RNA-positive, HBs-Ag-positive, NAFLD by hepatic ultrasound, iron overload and excessive alcohol use of > 20 g of alcohol per day with elevated liver enzymes) were excluded.Results. Of all adult NHANES III participants enrolled in 1988-1994 (n = 20,050), 9,207 individuals had sufficient demographic, clinical and medical information making them eligible for this study (age 41.26 ± 0.38, 46.76% male, 76.67% Caucasian, BMI 26.39 ± 0.38, 16.99% had diabetes or insulin resistance, 16.97% had hypertension, 65.28% had dyslipdemia). Of the entire study cohort, 90 (1.25%) participants reported using statins at the time of the interview. Median mortality follow-up for the study cohort was 175.54 months. During this period, 1,330 individuals (11.25%) died with 26 (0.17%) being liver-related deaths. For the cohort using statins, there were 37 deaths (40.15%) after a median follow-up of 143.35 months. In fact, the top cause of death for statin users was cardiac related (16 cases, 33.62%). However, after adjusting for major demographic, clinical and metabolic confounders, statin use was not associated with cardiovascular deaths in males (Hazard Ratio, 0.79, 95% Confidence Interval, 0.30-2.13), but was associated with higher risk of cardiovascular deaths in females (odds ratio, 2.32, 95% confidence interval, 1.58-3.40). Furthermore, the rate of liver-related mortality was significantly lower (p = 0.0035) among statin users compared to non-statin users.Conclusions. After a decade of follow up, there was no association between statin use and liver-related mortality.http://www.sciencedirect.com/science/article/pii/S1665268119309081StatinLiver diseaseMortality |
| spellingShingle | Zahra Younoszai Li Zheng Maria Stepanova Madeline Erario Rebecca Cable Zobair M. Younossi Statin use is not associated with liver related mortality Annals of Hepatology Statin Liver disease Mortality |
| title | Statin use is not associated with liver related mortality |
| title_full | Statin use is not associated with liver related mortality |
| title_fullStr | Statin use is not associated with liver related mortality |
| title_full_unstemmed | Statin use is not associated with liver related mortality |
| title_short | Statin use is not associated with liver related mortality |
| title_sort | statin use is not associated with liver related mortality |
| topic | Statin Liver disease Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119309081 |
| work_keys_str_mv | AT zahrayounoszai statinuseisnotassociatedwithliverrelatedmortality AT lizheng statinuseisnotassociatedwithliverrelatedmortality AT mariastepanova statinuseisnotassociatedwithliverrelatedmortality AT madelineerario statinuseisnotassociatedwithliverrelatedmortality AT rebeccacable statinuseisnotassociatedwithliverrelatedmortality AT zobairmyounossi statinuseisnotassociatedwithliverrelatedmortality |