Severe hepatic injury associated with different statins in patients with chronic liver disease: A nationwide population-based cohort study

被引：36

作者：

Chang, Chia-Hsuin ^{[1
,2
,3
]}

Chang, Yi-Cheng ^{[2
,3
,4
]}

Lee, Yen-Chieh ^{[1
,5
]}

Liu, Ying-Chun ^{[1
]}

Chuang, Lee-Ming ^{[1
,2
,3
]}

Lin, Jou-Wei ^{[2
,6
]}

机构：

[1] Natl Taiwan Univ, Coll Publ Hlth, Inst Prevent Med, Hsinchu, Taiwan

[2] Natl Taiwan Univ, Dept Med, Coll Med, Hsinchu, Taiwan

[3] Natl Taiwan Univ Hosp, Dept Internal Med, Hsinchu, Taiwan

[4] Natl Taiwan Univ Hosp, Dept Internal Med, HsinChu Branch, Hsinchu, Taiwan

[5] Cathay Gen Hosp, Dept Family Med, Taipei, Taiwan

[6] Natl Taiwan Univ Hosp, Cardiovasc Ctr, Yun Lin Branch, Dou Liou City, Yun Lin County, Taiwan

来源：

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY | 2015年 / 30卷 / 01期

关键词：

acute hepatic injury; atorvastatin; chronic liver disease; National Health Insurance; statin; HIGH-DOSE ATORVASTATIN; HEPATOTOXICITY; LOVASTATIN; PREVENTION; CAUSALITY; ATHEROSCLEROSIS; FLUVASTATIN; SIMVASTATIN; INFECTION; EFFICACY;

D O I：

10.1111/jgh.12657

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and AimThe hepatotoxicity of statins in patients with chronic liver diseases remains unclear. In this study, we aimed to estimate the risk of severe hepatic injury associated with different statins in patients with chronic liver disease. MethodsA nationwide population-based cohort study was conducted by analyzing the Taiwan National Health Insurance database. A total of 37929 subjects with chronic liver disease who started statin therapy were identified during the period of January 1, 2005 to December 31, 2009. Outcome was defined as hospitalization due to liver injury. ResultsDuring a total of 118772 person-years of follow-up, 912 incident cases of hospitalization due to hepatic injury are identified. The incidence rate was 2.95, 2.49, 2.92, 1.94, 2.65, and 2.52 per 100000 person-days for atorvastatin, lovastatin, fluvastatin, pravastatin, simvastatin, and rosuvastatin initiators, respectively. Overall, there was no difference in the incidence associated with different statins. However, when each statin was further categorized to high (0.5 defined daily dose) or low (<0.5 defined daily dose) mean daily dose, only high-dose atorvastatin was significantly associated with increased risk of hospitalization due to hepatic injury (hazard ratio, 1.62; 95% confidence interval, 1.29, 2.03) as compared with low-dose atorvastatin. ConclusionThe overall incidence of hospitalization due to severe hepatic injury was low among statin initiators with chronic liver disease. Only high-dose atorvastatin was associated with increased risk.

引用

页码：155 / 162

页数：8

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