P2881 - Utilization of High Intensity Statins May Protect Against Decompensation in Alcohol-Associated Liver Disease

Nariman Hossein-Javaheri, DO¹, Himaben Gohil, DO¹, Ikjot Singh, MD¹, Blake Podger, DO¹, Ahmad Abulawi, MD², Anthony Martinez, MD^1
1University at Buffalo, Buffalo, NY; ²Albany Medical Center, Albany, NY

Introduction: Heavy alcohol use can negatively impact the liver and cardiovascular systems. As such, the American Heart Association has endorsed the use of statins in chronic/stable liver disease for secondary prevention of atherosclerotic cardiovascular disease (ASCVD). This might benefit those with alcohol-associated liver disease (ALD) however the specifics on the intensity of the statin remain equivocal. Moreover, there exists a knowledge gap regarding the benefit of statin therapy in ALD in terms of the incidence of hepatic encephalopathy (HE), ascites, or gastrointestinal bleeding (GIB). Herein we present a retrospective study comparing the effect of different intensity statins on HE, GIB, and ascites.

Methods: On admission, 55 patients with hyperlipidemia and ALD on statin therapy were identified. They were stratified into groups based on statin intensity. Data on the following was collected for each group: demographics, atherosclerotic cardiovascular disease (ASCVD) risk scores, presence of cirrhosis, MELD scores, signs of decompensation, and 90-day mortality. Results were presented as mean ±SEM and groups were compared using ANOVA with statistical significance being p< 0.05.

Results: 34.5% (n=19) were on high-intensity statins while 63.6% (n=35) were on moderate-intensity statins. Those on high-intensity statins were significantly older (61.1±1.3 vs 55.5±1.8 years; p< 0.001) with greater ASCVD risk (21.7±2.9 vs 11.7±1.6; p< 0.01). The percentage of cirrhosis (42.1% vs 60%; p=0.1) and MELD scores (8.9±1.7 vs 12.7±1.8; p >0.05) were not significantly different between the two groups; however, those on high-intensity statins had lower rates of HE (20% vs 32.3%; p=0.15), GI bleeding (5% vs 26.4%; p=0.01), and ascites (15% vs 23.5%; p=0.2). There were no mortality benefits in those receiving high vs moderate intensity statins (7.7% vs7.4%; p=0.5).

Discussion: This retrospective study showed patients with ALD have high to moderate risks of ASCVD. Additionally, high-intensity statin may have some protective effect regarding the incidence of decompensation with a significantly reduced risk of GIB. Our study did not show a mortality benefit between the high and moderate-intensity statin. However, a recent population-based study in South Korea suggested that high-intensity statin may provide mortality benefits in chronic liver disease patients with ASCVD. Hence, high-intensity statin may be beneficial in ALD, but further investigation is required to understand its full utility.


Disclosures:


Nariman Hossein-Javaheri, DO¹, Himaben Gohil, DO¹, Ikjot Singh, MD¹, Blake Podger, DO¹, Ahmad Abulawi, MD², Anthony Martinez, MD¹. P2881 - Utilization of High Intensity Statins May Protect Against Decompensation in Alcohol-Associated Liver Disease, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.