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The Use of Statins in Patients With Chronic Liver Disease and Cirrhosis

  • Carlos Moctezuma-Velázquez
  • Juan G. Abraldes
  • Aldo J. Montano-Loza
Liver (J Bajaj, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Liver

Abstract

Purpose of review

Statins are drugs developed to treat hypercholesterolemia. Its use in patients with liver disease has been limited because one of its potential and most feared side effects is hepatotoxicity. However, there is robust evidence that supports the safety of statins in this population in the absence of severe liver dysfunction. In this review, we will summarize the efficacy and safety of statins in cirrhosis.

Recent findings

Statins are effective in the treatment of dyslipidemia in patients with liver disease, because of their pleiotropic properties. These properties are independent of their effect on cholesterol levels, such as improving endothelial dysfunction or having antioxidant, antifibrotic, anti-inflammatory, antiproliferative, antiangiogenic, proapoptotic, or immunomodulation properties. Statins have been studied in other areas such as in treatment of portal hypertension, prevention of hepatocellular carcinoma, and/or protection against ischemia/reperfusion injury.

Summary

Approved indications for statins in patients with cirrhosis are those of the general population, including dyslipidemia and increased cardiovascular risk. Compensated cirrhosis is not a contraindication. In patients with decompensated cirrhosis, statins should be prescribed with extreme caution at low doses, and with frequent monitoring of creatinine phosphokinase levels in order to detect adverse events in a timely fashion.

Keywords

Hydroxymethylglutaryl-CoA reductase inhibitors Liver cirrhosis End-stage liver disease Chemical- and drug-induced liver injury Hypertension, portal Dyslipidemias 

Notes

Compliance with Ethical Standards

Conflict of Interest

Carlos Moctezuma-Velázquez declares that he has no conflict of interest. Juan Abraldes declares that he has no conflict of interest. Aldo Montano-Loza declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Carlos Moctezuma-Velázquez
    • 1
  • Juan G. Abraldes
    • 1
  • Aldo J. Montano-Loza
    • 1
  1. 1.Division of Gastroenterology and Liver UnitUniversity of AlbertaEdmontonCanada

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