Association of Statin Therapy and Risks of Cholelithiasis, Biliary Tract Diseases, and Gallbladder Procedures: Retrospective Cohort Analysis of a US Population

Donald Martin, Robert Schmidt, Eric M. Mortensen, Ishak Mansi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Gallstone disease is a leading cause of morbidity in Western countries and carries a high economic burden. Statin medications decrease hepatic cholesterol biosynthesis and may, therefore, lower the risk of cholesterol cholelithiasis by reducing the cholesterol concentration in the bile. Population-based evidence, however, is sparse. Objective: To assess the risk of gallbladder diseases among statin users compared with nonusers in an American patient cohort. Methods: We performed a retrospective cohort study of patients enrolled in the San Antonio Tricare health system using data between October 2003 and March 2012. We defined 2 groups: statin users (use for 90 days or greater) and nonusers (no prior statin). A propensity score based on 82 variables was generated to match statin users and nonusers 1:1. Outcomes included incidence of cholelithiasis, biliary tract diseases, and gallbladder procedures. Results: A total of 43 438 patients were identified; 13 626 (31.4%) were statin users, and 29 812 (68.6%) were nonusers. We matched 6342 pairs of statin users and nonusers based on propensity score. The odds ratios (ORs) in statin users in comparison to nonusers were similar for cholelithiasis (OR = 0.86; 95% CI = 0.73, 1.02), biliary tract disease (OR = 0.85; 95% CI = 0.67-1.08), and gall bladder procedures (OR = 0.85; 95% CI = 0.69, 1.04). Conclusions: Statin use was not significantly associated with either an increased or decreased risk of cholelithiasis or gallbladder disease.

Original languageEnglish (US)
Pages (from-to)161-171
Number of pages11
JournalAnnals of Pharmacotherapy
Volume50
Issue number3
DOIs
StatePublished - Mar 1 2016

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Biliary Tract Diseases
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cholelithiasis
Gallbladder
Cohort Studies
Population
Odds Ratio
Gallbladder Diseases
Propensity Score
Therapeutics
Cholesterol
Gallstones
Information Systems
Bile
Urinary Bladder
Retrospective Studies
Economics
Morbidity

Keywords

  • cholelithiasis
  • cholesterol
  • statins

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

@article{07c2e38462cc4e809ae33132c8ea12c1,
title = "Association of Statin Therapy and Risks of Cholelithiasis, Biliary Tract Diseases, and Gallbladder Procedures: Retrospective Cohort Analysis of a US Population",
abstract = "Background: Gallstone disease is a leading cause of morbidity in Western countries and carries a high economic burden. Statin medications decrease hepatic cholesterol biosynthesis and may, therefore, lower the risk of cholesterol cholelithiasis by reducing the cholesterol concentration in the bile. Population-based evidence, however, is sparse. Objective: To assess the risk of gallbladder diseases among statin users compared with nonusers in an American patient cohort. Methods: We performed a retrospective cohort study of patients enrolled in the San Antonio Tricare health system using data between October 2003 and March 2012. We defined 2 groups: statin users (use for 90 days or greater) and nonusers (no prior statin). A propensity score based on 82 variables was generated to match statin users and nonusers 1:1. Outcomes included incidence of cholelithiasis, biliary tract diseases, and gallbladder procedures. Results: A total of 43 438 patients were identified; 13 626 (31.4{\%}) were statin users, and 29 812 (68.6{\%}) were nonusers. We matched 6342 pairs of statin users and nonusers based on propensity score. The odds ratios (ORs) in statin users in comparison to nonusers were similar for cholelithiasis (OR = 0.86; 95{\%} CI = 0.73, 1.02), biliary tract disease (OR = 0.85; 95{\%} CI = 0.67-1.08), and gall bladder procedures (OR = 0.85; 95{\%} CI = 0.69, 1.04). Conclusions: Statin use was not significantly associated with either an increased or decreased risk of cholelithiasis or gallbladder disease.",
keywords = "cholelithiasis, cholesterol, statins",
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T1 - Association of Statin Therapy and Risks of Cholelithiasis, Biliary Tract Diseases, and Gallbladder Procedures

T2 - Retrospective Cohort Analysis of a US Population

AU - Martin, Donald

AU - Schmidt, Robert

AU - Mortensen, Eric M.

AU - Mansi, Ishak

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: Gallstone disease is a leading cause of morbidity in Western countries and carries a high economic burden. Statin medications decrease hepatic cholesterol biosynthesis and may, therefore, lower the risk of cholesterol cholelithiasis by reducing the cholesterol concentration in the bile. Population-based evidence, however, is sparse. Objective: To assess the risk of gallbladder diseases among statin users compared with nonusers in an American patient cohort. Methods: We performed a retrospective cohort study of patients enrolled in the San Antonio Tricare health system using data between October 2003 and March 2012. We defined 2 groups: statin users (use for 90 days or greater) and nonusers (no prior statin). A propensity score based on 82 variables was generated to match statin users and nonusers 1:1. Outcomes included incidence of cholelithiasis, biliary tract diseases, and gallbladder procedures. Results: A total of 43 438 patients were identified; 13 626 (31.4%) were statin users, and 29 812 (68.6%) were nonusers. We matched 6342 pairs of statin users and nonusers based on propensity score. The odds ratios (ORs) in statin users in comparison to nonusers were similar for cholelithiasis (OR = 0.86; 95% CI = 0.73, 1.02), biliary tract disease (OR = 0.85; 95% CI = 0.67-1.08), and gall bladder procedures (OR = 0.85; 95% CI = 0.69, 1.04). Conclusions: Statin use was not significantly associated with either an increased or decreased risk of cholelithiasis or gallbladder disease.

AB - Background: Gallstone disease is a leading cause of morbidity in Western countries and carries a high economic burden. Statin medications decrease hepatic cholesterol biosynthesis and may, therefore, lower the risk of cholesterol cholelithiasis by reducing the cholesterol concentration in the bile. Population-based evidence, however, is sparse. Objective: To assess the risk of gallbladder diseases among statin users compared with nonusers in an American patient cohort. Methods: We performed a retrospective cohort study of patients enrolled in the San Antonio Tricare health system using data between October 2003 and March 2012. We defined 2 groups: statin users (use for 90 days or greater) and nonusers (no prior statin). A propensity score based on 82 variables was generated to match statin users and nonusers 1:1. Outcomes included incidence of cholelithiasis, biliary tract diseases, and gallbladder procedures. Results: A total of 43 438 patients were identified; 13 626 (31.4%) were statin users, and 29 812 (68.6%) were nonusers. We matched 6342 pairs of statin users and nonusers based on propensity score. The odds ratios (ORs) in statin users in comparison to nonusers were similar for cholelithiasis (OR = 0.86; 95% CI = 0.73, 1.02), biliary tract disease (OR = 0.85; 95% CI = 0.67-1.08), and gall bladder procedures (OR = 0.85; 95% CI = 0.69, 1.04). Conclusions: Statin use was not significantly associated with either an increased or decreased risk of cholelithiasis or gallbladder disease.

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