Journal of clinical lipidology · 2026
Mortality, cardiovascular, and hepatic decompensation outcomes of bempedoic acid in patients with cirrhosis: A multi-institutional study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Osman Mohamad Mahdi, Massad Talal, Sims Omar T, Chiang Dian J
Аннотация
BACKGROUND: Data on bempedoic acid in cirrhosis are limited.
OBJECTIVE: To evaluate associations between bempedoic acid use and clinical outcomes in adults with cirrhosis.
METHODS: We conducted a retrospective TriNetX cohort study comparing adults with cirrhosis receiving versus not receiving bempedoic acid. Patients with end-stage renal disease or prior liver transplantation were excluded. Propensity score matching was performed 1:1 using demographic, clinical, medication, and laboratory variables. Outcomes were mortality, hospitalization, hepatic decompensation, and major adverse cardiovascular events.
RESULTS: After matching, 325 pairs were analyzed. Bempedoic acid use was associated with lower all-cause mortality (hazard ratio [HR], 0.28; 95% CI, 0.17-0.45; P < 0.001) and all-cause hospitalization (HR, 0.52; 95% CI, 0.40-0.68; P < 0.001). No significant differences were observed in hepatic decompensation (HR, 0.96; 95% CI, 0.62-1.50; P = .86) or MACE (HR, 0.84; 95% CI, 0.50-1.39; P = .49) did not differ.
CONCLUSION: Bempedoic acid was associated with lower mortality and hospitalization without increased hepatic decompensation. Residual confounding and immortal time bias limit causal interpretation.
OBJECTIVE: To evaluate associations between bempedoic acid use and clinical outcomes in adults with cirrhosis.
METHODS: We conducted a retrospective TriNetX cohort study comparing adults with cirrhosis receiving versus not receiving bempedoic acid. Patients with end-stage renal disease or prior liver transplantation were excluded. Propensity score matching was performed 1:1 using demographic, clinical, medication, and laboratory variables. Outcomes were mortality, hospitalization, hepatic decompensation, and major adverse cardiovascular events.
RESULTS: After matching, 325 pairs were analyzed. Bempedoic acid use was associated with lower all-cause mortality (hazard ratio [HR], 0.28; 95% CI, 0.17-0.45; P < 0.001) and all-cause hospitalization (HR, 0.52; 95% CI, 0.40-0.68; P < 0.001). No significant differences were observed in hepatic decompensation (HR, 0.96; 95% CI, 0.62-1.50; P = .86) or MACE (HR, 0.84; 95% CI, 0.50-1.39; P = .49) did not differ.
CONCLUSION: Bempedoic acid was associated with lower mortality and hospitalization without increased hepatic decompensation. Residual confounding and immortal time bias limit causal interpretation.