ArticleDigestive diseases and sciences2026
Statin Continuation After an Index Hospitalization for Hepatic Decompensation in MASLD Cirrhosis.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWhether established statin therapy should be continued after hospitalization for hepatic decompensation in metabolic dysfunction-associated steatotic liver disease (MASLD) cirrhosis remains uncertain.
methodsWe performed a retrospective multicenter cohort study in the TriNetX Research network. Adults aged 18-75 years with MASLD cirrhosis, a qualifying inpatient decompensation event, and a statin record before index were classified by whether a statin was recorded from the index date through day 30. Propensity score matching was used to improve balance across demographics, comorbidities, liver-related features, medications, and laboratory values. Outcomes were evaluated through 1 year using platform-generated survival analyses.
resultsThe matched analysis included 1,108 patients (554 per group). At 1 year, statin continuation was not associated with the subsequent decompensation composite (62.1% vs 61.6%; HR 1.08, 95% CI 0.93-1.26) or all-cause mortality (19.7% vs 19.5%; HR 1.04, 95% CI 0.80-1.36). Subsequent ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, the cardiovascular composite, and the muscle and laboratory liver injury composites also did not differ. Liver transplantation was less frequent (2.3% vs 6.1%; HR 0.38, 95% CI 0.20-0.73), whereas all-cause hospitalization was more frequent (62.6% vs 57.8%; HR 1.20, 95% CI 1.03-1.40). Exploratory high-intensity analyses showed higher decompensation, hepatic encephalopathy, and hospitalization.
conclusionsAmong prevalent statin users with MASLD cirrhosis, continuation after an index decompensation hospitalization was not associated with lower 1-year decompensation or mortality. Isolated secondary and intensity findings are exploratory. Residual confounding, exposure misclassification, competing risk, and overlap between exposure classification and early follow-up limit causal interpretation; prospective and time-aligned studies are needed.
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