Long-term use of cholesterol-lowering statins does not increase the risk of liver disease in patients with abnormal liver function, and can actually improve liver function, according to a new study that challenges widespread belief.
The researchers also pointed out that this study is the first to show that statins provide a substantially greater cardiovascular benefit in patients with abnormal liver function than in those with normal liver function.
The study, published in the Nov. 24 online edition of The Lancet, included 437 patients with moderately abnormal liver tests believed to have non-alcoholic fatty liver disease. Statins were given to 227 patients, while the other 210 (the control group) received no treatment.
After three years of follow-up, the patients taking statins did not have a higher rate of liver problems than those in the control group. In addition, levels of alanine aminotransferase (ALT) -- a biomarker of liver problems -- decreased or normalized in the patients taking statins but worsened in the control group.
The investigators also found that patients with abnormal liver tests who took statins had a 39 percent to 68 percent reduced risk of cardiovascular events such as heart attack and stroke.
"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," Vasilis Athyros, of the Hippokration University Hospital in Thessaloniki, Greece, Dr. Dimitri Mikhailidis, of University College London in the United Kingdom, and colleagues concluded.
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