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Hepatol Commun ; 5(10): 1755-1766, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34558822

RESUMEN

Complications of cirrhosis and portal hypertension (PH) can be reduced by statin therapy. The common loss-of-function variant p.V174A in the solute carrier organic anion transporter gene 1B1 (SLCO1B1) gene encoding the organic anion transporting polypeptide 1B1 results in decreased hepatic uptake of statins. Our specific aim was to assess the impact of this variant in patients with cirrhosis and statin treatment while controlling for the stage of cirrhosis and other potential confounders with propensity score matching (PSM), availing of a large cohort of genotyped study patients. In total, from 1,088 patients with cirrhosis in two German academic medical centers, PSM yielded 154 patients taking statins and 154 matched controls. The effect on PH was assessed by the liver stiffness-spleen size-to-platelet score (LSPS), and complications of cirrhosis were retrospectively recorded applying consensus criteria. As hypothesized, patients on statin treatment presented less frequently with signs of PH: Esophageal varices (41% vs. 62%; P < 0.001) were less common, and LSPS (4.8 ± 11.5 vs. 5.6 ± 6.4; P = 0.01) was reduced. Correspondingly, decompensation events were also reduced in patients on statins (odds ratio [OR] = 0.54, 95% confidence interval [CI] 0.32-0.90; P = 0.02). When the variant in SLCO1B1 was present in patients on statins, esophageal varices (OR = 2.68, 95% CI 1.24-5.81; P = 0.01) and bacterial infections (OR = 2.50, 95% CI 1.14-5.47; P = 0.02) were more common as compared with wild type carriers on statins. Conclusion: In this cohort, signs and complications of PH were reduced in patients with cirrhosis treated with statins. Notably, this effect was diminished by the common loss-of-function variant in SLCO1B1. Further prospective studies in independent cohorts are warranted to confirm these genotype-specific observations.


Asunto(s)
Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Hipertensión Portal/genética , Cirrosis Hepática/genética , Transportador 1 de Anión Orgánico Específico del Hígado/genética , Sustancias Protectoras/uso terapéutico , Anciano , Infecciones Bacterianas/inducido químicamente , Infecciones Bacterianas/genética , Várices Esofágicas y Gástricas/inducido químicamente , Várices Esofágicas y Gástricas/genética , Femenino , Predisposición Genética a la Enfermedad/genética , Predisposición Genética a la Enfermedad/prevención & control , Genotipo , Humanos , Hipertensión Portal/prevención & control , Hígado/efectos de los fármacos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/tratamiento farmacológico , Mutación con Pérdida de Función , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Puntaje de Propensión , Estudios Retrospectivos
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