Statins decrease the risk of decompensation in hepatitis B virus- and hepatitis C virus-related cirrhosis: A population-based study.
Statin use decreases the risk of decompensation and mortality in patients with cirrhosis due to hepatitis C virus (HCV). Whether this beneficial effect can be extended to cirrhosis in the general population or cirrhosis due to other causes, such as hepatitis B virus (HBV) infection or alcohol, remains unknown. Statin use also decreases the risk of hepatocellular carcinoma (HCC) in patients with chronic HBV and HCV infection. It is unclear whether the effect can be observed in patients with pre-existing cirrhosis. The goal of this study was to determine the effect of statin use on rates of decompensation, mortality, and HCC in HBV-, HCV-, and alcohol-related cirrhosis. Patients with cirrhosis were identified from a representative cohort of Taiwan National Health Insurance beneficiaries from 2000 to 2013. Statin users, defined as having a cumulative defined daily dose (cDDD) ≥28, were selected and served as the case cohort. Statin nonusers (<28 cDDD) were matched through propensity scores. The association between statin use and risk of decompensation, mortality, and HCC were estimated. A total of 1350 patients with cirrhosis were enrolled. Among patients with cirrhosis, statin use decreased the risk of decompensation, mortality, and HCC in a dose-dependent manner (P for trend <0.0001, <0.0001, and 0.009, respectively). Regression analysis revealed a lower risk of decompensation among statin users with cirrhosis due to chronic HBV (adjusted hazard ratio [HR], 0.39; 95% confidence interval [CI], 0.25-0.62) or HCV infection (HR, 0.51; 95% CI, 0.29-0.93). The lowered risk of decompensation was of borderline significance among statin users with alcohol-related cirrhosis (HR, 0.69; 95% CI, 0.45-1.07).



Statin use decreases the decompensation rate in both HBV- and HCV-related cirrhosis. Of borderline significance is a decreased decompensation rate in alcohol-related cirrhosis. (Hepatology 2017;66:896-907).
Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.|Yuanshan Branch, Taipei Veterans General Hospital, I-Lan, Taiwan.|Department of Medicine, National Yang-Ming University, Taipei, Taiwan.
Fu-Ming
FM
Chang
Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Medicine, National Yang-Ming University, Taipei, Taiwan.|Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.|Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
Yen-Po
YP
Wang
Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
Hui-Chu
HC
Lang
Department of Medicine, National Yang-Ming University, Taipei, Taiwan.|Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.|Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Chia-Fen
CF
Tsai
Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Medicine, National Yang-Ming University, Taipei, Taiwan.|Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.
Ming-Chih
MC
Hou
Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Medicine, National Yang-Ming University, Taipei, Taiwan.
Fa-Yauh
FY
Lee
Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Medicine, National Yang-Ming University, Taipei, Taiwan.|Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
Ching-Liang
CL
Lu
D000368:Aged; D016022:Case-Control Studies; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000187:drug effects; D006515:Hepatitis B virus / Q000187:drug effects; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control / Q000821:virology*; D017093:Liver Failure / Q000401:mortality / Q000517:prevention & control* / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012720:Severity of Illness Index; D013624:Taiwan; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors