The Use of Statin in Patient with Acute Pancreatitis: Is It Beneficial or Does It Increase the Risk?

Abstract

Introduction: Acute pancreatitis (AP) is the most common gastrointestinal discharge diagnosis in the United States. Statins are now among the most widely prescribed medications worldwide. Beside their benfit on lipid regulation they also have a potential anti-inflammatory effect.There has been increasing controversial evidence linking statins to a potential increased risk of causing AP and other studies have shown benefit among statin users and better outcomes in this group. We investigate the positive and negative associations between statin users vs. non-statin users during an acute pancreatitis episode. Methods: We performed a retrospective cohort study of consecutive patients admitted for acute pancreatitis at a large public hospital during 01/2013 and 12/2014. We identified acute pancreatitis by ICD9 code or lipase ≥ 3 times the normal upper limit. We identified patients who were currently taking statin for the at least one month and include them to our statin-user group to compare them with the non-statin users group. We tested for mortality benefit, incidence of Persistent SIRS, AKI, pancreatic necrosis and Hospital readmissions as well as differences in AP etiology. We constructed multivariable logistic regression models using STATA software version 13. Results: We retrospectively analyzed 460 consecutive patients admitted with a first episode of acute pancreatitis. The Statin-user group (79 patients, 17%) was not significantly different than the non-statin users. After adjusting for age and gender, no significant differences on SIRS, Persistent SIRS, pancreatic necrosis or Mortality benefit were found (p=NS). However, that Statin-user group had significantly fewer re-hospitalizations after the AP episode (OR 0.23, p < 0.001; CI 0.02-0.43). No Plausible differences between etiologies were found (p=NS). Conclusion: Limitations: Retrospective study. Strength: Robust patient cohort. Absence of transferred patients. Conclusion: Statin use was not significantly associated with either an increased or decreased risk of acute pancreatitis. Moreover, Statin did not have a protective effect on Multi-organ failure or pancreatic necrosis. It did reveal a protective effect for hospital readmissions. Further Randomized Control Trials are needed to assess the potential benefit of statins.