ArticleJournal of hepatology2022
Statin exposure is associated with reduced development of acute-on-chronic liver failure in a Veterans Affairs cohort.
Article in Journal of hepatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- A Systematic Review of Statins for the Treatment of Nonalcoholic Steatohepatitis: Safety, Efficacy, and Mechanism of Action.Molecules (Basel, Switzerland) · 2024Pooled it
- KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications 2026.Clinical and molecular hepatology · 2026Article
- Acute-on-chronic liver failure: From definition to pathogenesis and therapy.Chinese medical journal · 2026Review
- Simvastatin in liver diseases: therapeutic value and research advances.Clinical and experimental medicine · 2026Review
- Efficacy and Safety of Statins in MASLD and Other Chronic Liver Diseases.Medical sciences (Basel, Switzerland) · 2026Review
- Disease Modulating Agents in Cirrhosis.Clinics in liver disease · 2026Review
- MetALD: decoding the evolution of steatotic liver disease nomenclature and implications for clinical practice and beyond.Gastroenterology report · 2026Review
- Beyond cardiovascular protection: a conceptual and translational review of the hepato-specific mechanisms of statins in metabolic dysfunction-associated steatotic liver disease (MASLD).Frontiers in pharmacology · 2026Review
- Met-ALD and ALD- Does Differentiating These Impact Management and Clinical Outcomes?Current hepatology reports · 2025Article
- Statins and clinical outcomes in patients with advanced hepatocellular carcinoma treated with Atezolizumab plus Bevacizumab.Scientific reports · 2025Article
- Acute-on-Chronic Liver Failure: Steps Towards Consensus.Diagnostics (Basel, Switzerland) · 2025Review
- Potential therapies for acute-on-chronic liver failure.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Review
- Phenotyping Hepatic Immune-Related Adverse Events in the Setting of Immune Checkpoint Inhibitor Therapy.JCO clinical cancer informatics · 2024Article
- Rates, patterns, and predictors of specialty palliative care consultation among patients with acute-on-chronic liver failure.JHEP reports : innovation in hepatology · 2024Article
- The Impact of Statins on the Survival of Patients with Advanced Hepatocellular Carcinoma Treated with Sorafenib or Lenvatinib.Cancers · 2024Article
- Review of the role of statins in cirrhosis and portal hypertension.Clinical liver disease · 2023Article
- Acute-On-Chronic Liver Failure: Current Interventional Treatment Options and Future Challenges.Journal of personalized medicine · 2023Review
- Association between statin exposure and short-term mortality in patients with high-grade acute-on-chronic liver failure.JHEP reports : innovation in hepatology · 2023Article
- NAFLD: A pretransplant and post-transplant conundrum.Clinical liver disease · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUNDS &
aimsThere is a need to identify therapies that prevent the development of acute-on-chronic liver failure (ACLF) in patients with cirrhosis. This study sought to evaluate the association between statin exposure and the risk of developing ACLF in a large national cohort of patients with cirrhosis.
methodsWe performed a retrospective cohort study of patients diagnosed with cirrhosis within the Veterans Health Administration from 2008 and 2018. Patients were stratified into 3 groups based on statin exposure (statin naïve, existing statin user, and new statin initiator). Cox proportional hazards regression models with inverse probability treatment weighting and marginal structural models were utilized to comprehensively address potential confounding in estimating the association between time-updated statin exposure and first occurrence of high-grade ACLF.
resultsThe cohort included 84,963 patients, of whom 26.9% were on a statin at baseline. A total of 8,558 (10.1%) patients with cirrhosis were hospitalized with high-grade ACLF over a median follow-up time of 51.6 months (IQR 27.5-81.4). Time-updated statin use was associated with a significant reduction in the hazard of developing ACLF (hazard ratio [HR] 0.62, 95% CI 0.59-0.65, p <0.001). Increasing doses of statin were associated with progressively reduced hazard of developing ACLF (HR 0.75, 95% CI 0.66-0.86, p <0.001 for <20 mg vs. 0 mg of time-updated statin exposure, in simvastatin equivalents; HR 0.61, 95%, CI 0.58-0.64, p <0.001 for >20 mg vs. 0 mg statin exposure). Furthermore, every additional 5 months of statin exposure was associated with a 9% reduced hazard of high-grade ACLF (HR 0.91, 95% CI 0.90-0.92, p <0.001).
conclusionsIn this large, retrospective, cohort study in patients with cirrhosis, statin use was significantly associated with reduced development of high-grade ACLF. LAY SUMMARY: Statin therapy has been shown to have numerous beneficial effects in patients with chronic liver disease. This study demonstrated a strong association between statin therapy and a reduced risk of acute-on-chronic liver failure development in patients with cirrhosis. The results of this study support the promising role that statins may play in future prevention of acute-on-chronic liver failure in patients with cirrhosis.
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