Reduced risk of decompensation and death associated with use of statins in patients with alcoholic cirrhosis. A nationwide case-cohort study

Background:Reports have indicated that the use of statins may ameliorate the course of cirrhosis. Aim:To determine the relationship between use of statins and mortality rate in patients with cirrhosis. Methods:We did a retrospective case-cohort analysis based on data from the Danish registers from the period 1995 through 2014. Index date was time of diagnosis of cirrhosis (ICD-10:K703) and cohort entry depended on whether the patient was statin user or not. We used propensity score matching with a statin:non-statin ratio of 1:2. We included the exposure to statins (ATC classification C10AA) from the index date until death or end of follow-up based on prescription claims. Use of statins based on at least two statin claims as well as the longitudinal pattern over time of statin claims was tested against mortality. The main outcome was mortality rate. Results:A total of 24 748 patients with alcoholic cirrhosis were identified and 5417 were eligible for matching. The mean age was 56 (SD 10) years and 36% were females. The prevalence of use of statins was 15%. We included 744 in the matched cohort. Mortality rates were 88 (95% CI 73-105) per 1000 years for patients using statin and 127 (95% CI 114-141) for non-statin patients with a HR of 0.57 (95% CI 0.45-0.71). A more regular pattern of statin claims was related to a lower risk of death. Conclusions:Our results showed an association between regular use of statins and reduced mortality in patients with alcoholic cirrhosis.