The Lancet: statins are used to reduce repeat heart problems, but little is known about their effect in people with abnormal liver function.
Greek scientists studied 1,600 patients under 75 with heart and blood vessel disease, cholesterol above 2.6 mmol/L and triglycerides below 4.5 mmol/L. All the patients were offered statin treatment.
The study found that heart patients with "moderate" liver abnormalities not caused by alcohol were less likely to have another heart problem if they took statins than if they did not. Moderate liver abnormality was defined as raised liver enzymes (ALT or AST) below three times the normal limit.
Patients with moderate liver abnormalities took an average of 24 mg of atorvastatin a day, and their liver enzymes improved, while those who did not take statins got worse. 10% of the liver patients treated with statins had a heart event, compared with 30% of those not treated. This is a much bigger difference than in heart patients without liver abnormalities, where heart events occurred in 14% of those treated with statins and 23% of those not treated.
Fewer than 1% stopped statins because of side effects on the liver, with enzymes rising above three times the normal limit.
The study concluded that statin treatment is safe and beneficial for patients with mild to moderate liver abnormalities, and that it reduced deaths.
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