Evaluating the derangement of LFTs concerning statin use and probable liver injury among non-cardiac patients, in the light of R ratio.

Abstract

Background: To evaluate the derangement of Liver Function Tests (LFTs) concerning statin use and probable liver injury among non-cardiac patients in light of the R ratio. 

Methodology: This retrospective observational cohort study was conducted at Sindh Government Hospital Liaquatabad (SGHL) in Karachi, including 142 non-cardiac patients. Both male and female patients, aged ≥ 18 years, continuously using statin irrespective of dose or duration, were included in the study. While non-alcoholic fatty liver disease (NAFLD) patients, those with alcoholic liver diseases, chronic or acute hepatitis, chronic renal failure, disorders of the thyroid or parathyroid glands, cardiovascular, endocrine and any other disease that might alter or elevate liver enzymes, recreational drug users, smokers, users of tobacco products and those patients using herbal medications were excluded from the study sample. The data regarding patients' characteristics, including demographics and clinical characteristics (LFTs result and treatment), were obtained from the hospital records and noted using a structured questionnaire. The R ratio for suspected drug-induced liver injury was calculated following the American College of Gastroenterology (ACG) guidelines. The statistical analysis was performed on SPSS version 22.0

Results: The enrolled patients predominantly used rosuvastatin 20 mg/day 124(87.3%), and the mean duration of statin use after the first prescription was 18.28 ± 14.33 months. The LFT levels were mildly elevated concerning statin use, and this borderline elevation did not require further investigation, nor was there any evidence of clinical liver injury. The mean R ratio was 1.81 ± 0.56; most cases presented a cholestatic picture 86(60.6%) complementing the liver safety profile of statins in patients without cardiac diseases.

Conclusion: In conclusion, statins use caused only borderline clinically and statistically insignificant elevations in the LFTs over time among non-cardiac patients.