Addition of simvastatin to the standard therapy increases survival and is safe in patients with decompensated cirrhosis

Abstract

Background: Death by cardiovascular events has reduced by statins due to altering atherosclerosis development. As of 2007, no data on the use of statins in patients with decompensated cirrhosis were available. Aims: To evaluate the simvastatin efficacy and safety in patients with decompensated cirrhosis and cardiovascular factors. Methods: We performed a matched cases-series study. The case group included patients who agreed to add simvastatin to the standard therapy. The series group included patients who did not accept to add this drug to the standard of care. Each group had nine patients. Age, gender, cirrhosis etiology, Child-Pugh class, and Model for End-Stage Liver Disease (MELD) score matched case and series group in a ratio 1:1. Results: The intervals between cirrhosis complications in the case and series groups were 33.6 ± 19.9 months and 9.4 ± 8.2 months, respectively, P = 0.0065 . There was a significant deterioration of the liver function, which was evaluated through Child-Pugh and MELD scores in the series group while it was not affected in the case group. Median survival in the case group was 107 months, whereas it was 20 months in the series group (HR = 0.14; P < 0.0001 ). On the other hand, no patient in the case group experienced simvastatin-related adverse events. Furthermore, no patient in the case or series groups developed cardiovascular events. Conclusions: The addition of simvastatin to the standard therapy in patients with decompensated cirrhosis and cardiovascular risk factors was efficient as it decreased the patient’s mortality. Furthermore, the simvastatin was safe as patients showed good tolerance, considering that they did not develop adverse effects or serious adverse effects.