Background: Patients with cirrhosis and portal hypertension face a high risk of
complications. Besides their anti-inflammatory and antifibrotic effects, statins
may reduce portal pressure and thus the risk of complications and mortality. We
aimed to investigate the effects of atorvastatin on hospital admissions,
mortality, inflammation, and lipidomics in cirrhosis with portal hypertension.
Methods: We performed a double-blinded, randomized, placebo-controlled
clinical trial among patients with cirrhosis and portal hypertension. Atorvastatin
(10–20 mg/d) was administered for 6 months. We measured splanchnic
hemodynamics, analyzed inflammatory markers, and performed lipidomics at
baseline and after 6 months.
Results: Seventy-eight patients were randomized, with 38 patients allocated to
atorvastatin and 40 patients to placebo. Fifty-nine patients completed 6 months
of intervention. Comparisons between changes in each group were calculated.
Liver-related complications and mortality were similar between the groups. The
HVPG and Model for End-stage Liver Disease score did not change between
groups (p=0.95 and 0.87, respectively). Atorvastatin decreased 3 of 42
inflammatory markers, CD62-L-selectin, matrix metalloproteinases-2, and TNFα (p-values: 0.005, 0.011, and 0.023, respectively), while lipidomics was not significantly changed.
Conclusions: In patients with cirrhosis, atorvastatin was safe to use, but did
not reduce mortality, the risk of liver-related complications, or the HVPG.
Atorvastatin induced minor anti-inflammatory effects and minor effects on lipids
during a 6-month treatment period