Abnormal Liver Tests May Improve With Statins

Cardiovascular morbidity also improves more than in those with normal liver tests

WEDNESDAY, Nov. 24 (HealthDay News) -- Statins can actually improve liver function in patients with abnormal liver tests, and those patients reap substantially greater cardiovascular benefits from the drugs compared to patients who have normal liver tests, according to research published online Nov. 24 in The Lancet.

Vasilios G. Athyros, M.D., of the Aristotle University of Thessaloniki in Greece, and colleagues conducted a post-hoc analysis of 1,600 patients in the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) study population, all of whom were under 75 years of age, had coronary heart disease, and had serum concentrations of low-density lipoprotein cholesterol above 2.6 mmol/L and triglycerides below 4.5 mmol/L. The purpose of the analysis was to assess whether statin therapy is safe and effective for patients with abnormal liver tests.

The researchers found that there were 437 study participants with moderately elevated liver tests at baseline; 227 who were treated with a statin had significant improvements in liver tests compared to the 210 participants not treated with a statin who had further increases in liver enzyme levels. The statin group had a 68 percent cardiovascular event relative risk reduction compared to the non-statin group, and the benefit was significantly greater than it was in the GREACE study population with normal liver tests. The incidence of statin discontinuation for elevation of transaminase concentrations more than three-times the upper limit of normal was less than 1 percent.

"Statin treatment reduced the risk for cardiovascular events by 68 percent in patients with abnormal liver tests (P < 0.0001). The statin-related relative risk reduction was greater in patients with abnormal liver tests than in those with normal liver tests," the authors conclude. "Thus, the risk-to-benefit ratio of long-term statin treatment (mainly with atorvastatin in this study) favors statin administration even for patients with moderately abnormal liver tests."

Several of the authors disclosed financial relationships with pharmaceutical companies.

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