Long-term liver-related outcomes and liver stiffness progression of statin usage in steatotic liver disease.
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Zhou Xiao-Dong, Kim Seung Up, Yip Terry Cheuk-Fung, Petta Salvatore, Nakajima Atsushi, Tsochatzis Emmanuel, Boursier Jérôme, Bugianesi Elisabetta, Hagström Hannes, Chan Wah Kheong, Romero-Gomez Manuel, Calleja José Luis, de Lédinghen Victor, Castéra Laurent, Sanyal Arun J, Goh George Boon-Bee, Newsome Philip N, Fan Jiangao, Lai Michelle, Fournier-Poizat Céline, Lee Hye Won, Wong Grace Lai-Hung, Armandi Angelo, Shang Ying, Pennisi Grazia, Llop Elba, Yoneda Masato, Saint-Loup Marc de, Canivet Clemence M, Lara-Romero Carmen, Gallego-Duràn Rocio, Asgharpour Amon, Teh Kevin Kim-Jun, Mahgoub Sara, Chan Mandy Sau-Wai, Lin Huapeng, Liu Wen-Yue, Targher Giovanni, Byrne Christopher D, Wong Vincent Wai-Sun, Zheng Ming-Hua, VCTE-Prognosis Study Group
Аннотация
AIM: To explore the effects of statins on the long-term risk of all-cause mortality, liver-related clinical events (LREs) and liver stiffness progression in patients with MASLD.
METHODS: This cohort study collected data on patients with MASLD undergoing at least two vibration-controlled transient elastography examinations at 16 tertiary referral centres. Cox regression analysis was performed to examine the association between statin usage and long-term risk of all-cause mortality and LREs stratified by compensated advanced chronic liver disease (cACLD): baseline liver stiffness measurement (LSM) of ≥10 kPa. Liver stiffness progression was defined as an LSM increase of ≥20% for cACLD and from <10 kPa to ≥10 or LSM for non-cACLD. Liver stiffness regression was defined as LSM reduction from ≥10 kPa to <10 or LSM decrease of ≥20% for cACLD.
RESULTS: We followed up 7988 patients with baseline LSM 5.9 kPa (IQR 4.6-8.2) for a median of 4.6 years. At baseline, 40.5% of patients used statins, and cACLD was present in 17%. Statin usage was significantly associated with a lower risk of all-cause mortality (adjusted HR=0.233; 95% CI 0.127 to 0.426) and LREs (adjusted HR=0.380; 95% CI 0.268 to 0.539). Statin usage was also associated with lower liver stiffness progression rates in cACLD (HR=0.542; 95% CI 0.389 to 0.755) and non-cACLD (adjusted HR=0.450; 95% CI 0.342 to 0.592), but not with liver stiffness regression (adjusted HR=0.914; 95% CI 0.778 to 1.074).
CONCLUSIONS: Statin usage was associated with a relatively lower long-term risk of all-cause mortality, LREs and liver stiffness progression in patients with MASLD.