Do Statins Increase the Risk of Esophageal Conditions? Findings from Four Propensity Score-Matched Analyses

Smith, Ioana; Schmidt, Robert A.; Halm, Ethan A.; Mansi, Ishak A.

doi:10.1007/s40261-017-0589-x

Cited by 7 publications

(7 citation statements)

References 42 publications

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“…Five of them were excluded since they did not report the outcome of interest whereas 1 article[25] was excluded because it was a conference abstract that duplicated an original study. [20] Finally, 4 studies (2 cross-sectional studies,[619] 1 case-control study,[18] and 1 cohort study[20]) with 14,505 participants were included in the data analysis. The literature review and study selection process are demonstrated in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

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Statins and gastroesophageal reflux disease

Wijarnpreecha

Panjawatanan

Leelasinjaroen

et al. 2019

Journal of Postgraduate Medicine

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Background/Objectives:Gastroesophageal reflux disease (GERD) is one of the common gastrointestinal disorders worldwide. Recent epidemiologic studies have suggested that use of statins may lower the risk of GERD although the results from different studies were inconsistent. This systematic review and meta-analysis were conducted with the aim to summarize all available data.Methods:A systematic literature review was performed using MEDLINE and EMBASE database from inception to December 2017. Cohort, case-control, and cross-sectional studies that compared the risk of GERD among statin users versus nonusers were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.Results:A total of 4 studies (1 case control, 1 cohort, and 2 cross-sectional studies) with 14,505 participants met the eligibility criteria and were included in the meta-analysis. The risk of GERD among statin users was numerically lower than nonusers with the pooled OR of 0.89 but the result did not achieve statistical significance (95% CI, 0.60–1.33). The statistical heterogeneity in this study was moderate (I2 = 54%).Conclusions:The current meta-analysis found that the risk of GERD was numerically lower among statin users although the pooled result did not reach statistical significance. Therefore, more studies are still needed to further clarify this potential benefit of statins.

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Section: Resultsmentioning

confidence: 99%

“…In fact, the decreased risk of GERD among statin users is observed by some epidemiologic studies although the results were inconclusive. [181920] These systematic review and meta-analysis were conducted with the aim to summarize all available evidence to assess the risk of GERD among statin users versus nonusers.…”

Section: Introductionmentioning

confidence: 99%

Statins and gastroesophageal reflux disease

Wijarnpreecha

Panjawatanan

Leelasinjaroen

et al. 2019

Journal of Postgraduate Medicine

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“…Eighty seven percent of males and 68 % of females were always eating legumes/pulses ≥ 3 servings or ≥ 150g /week. Almost all the patients were prescribed statin therapy and some of them showed gastroesophageal reflux disease (GERD) as a side effect of medication as it is linked to higher probabilities of being detected with esophagitis and gastroesophageal reflux disease [62]. In addition to this, obesity has also been linked with increased symptoms of GERD and requires special attention in cardiac obese patients [63].…”

Section: Discussionmentioning

confidence: 99%

Role of Dietary and Lifestyle Modifications in the Secondary Prevention of Biomarkers of Plaque recurrence in Omani Coronary Revascularized Patients

Ali

Al-Alawi

Sadiq

et al. 2020

J. Pharm. Nutr. Sci.

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Objective: To assess the role of various dietary and lifestyle modifications in the secondary prevention of biomarkers of plaque recurrence in Omani coronary revascularized patients.Methods: Seventy-two patients, from the outpatient cardiology clinic of Sultan Qaboos University Hospital, were included in the study after obtaining an informed consent. In a questionnaire-based study, we collected data about four lifestyle modifications; physical activity, weight reduction, dietary intake and healthy eating patterns and smoking or non-smoking status, in personal interviews. A modified previously validated study questionnaire, which comprised of a semi-quantitative food frequency questionnaire, was used to assess the demographic information, eating patterns, diet quality index score, and daily dietary intake of study participants. The data about patient’s baseline characteristics, revascularization information and biochemical laboratory tests was harvested from the SQUH’s electronic record system. The statistical analysis of data was made using R-studio v.7 and Microsoft excel v.7.Results: The males had higher educational level as compared to females and were more active than females. The data indicated that 16% males and females were diabetic, 10% males and 21% females were hypertensive, and 30% males and 42% females had both diabetes and hypertension. Forty eight percent males and 63% females had body mass index (BMI) >30. However, no significant (P < 0.05) differences were observed in the BMI, diabetes and hypertension status in males and females. Both genders had poor nutritional knowledge. Although the LDL-C and HDL-C values in males and females differed, they were within the normal therapeutic limits. The HbA1c and C-reactive protein values were above the normal ranges with no significant (P < 0.05) difference in both males and females. The average daily energy intake in males (2694 kcalories) was significantly higher compared to females (1603 kcalories). The proportionate contribution of energy from macronutrients was within the acceptable macronutrient distribution ranges. Omani diet score for males (75.5) and females (74.6) didn’t differ significantly (P < 0.05), indicating their adherence to healthy dietary patterns.Conclusions: The results suggest that dietary and lifestyle modifications play significant role in the secondary prevention of biomarkers of plaque recurrence in Omani coronary revascularized patients. Behavioral counseling to promote healthy modifications in dietary and lifestyle factors are therefore recommended in the secondary prevention of risk of plaque recurrence.

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“…9 In our study, aspirin use had no influence on the development of premalignant lesions, similarly to the results of other randomized trials. 2,12,13 Case-control or observational studies evaluating the interaction between gastric cancer and statin therapy showed a neutral effect, 14,15 while others have noticed a reduced rate of gastric cancer, [16][17][18] , or even an inverse effect.3 The present research identified a statistically significant protective role of statins (p = 0.006) against premalignant lesions in the studied population, while age over 50 years and smoking remain the most important risk factors for premalignant gastric lesions. Statin therapy might have a certain protective effect, but other factors related to the host's genetic susceptibility 19 and the complex interaction with environmental risk factors should be considered in further large models.…”

Section: Discussionmentioning

confidence: 99%

“…1 A growing body of research investigated the effect of statins on gastrointestinal disorders, with controversial results. 1,2 Used to lower cholesterol levels and prevent the progression of atherosclerosis, statins are also known to reduce the incidence of different types of cancers, including gastric cancer, due to their anti-inflammatory and immunomodulatory effects. 3,4 Even though statins may be protective in the setting of cancer, their influence on the risk of gastrointestinal bleeding is a matter of concern, as the study results are controversial.…”

Section: Introductionmentioning

confidence: 99%

Chronic Statin Therapy and Histologic Gastric Changes

Negovan

Ţilea

Voidăzan

et al. 2018

Journal of Interdisciplinary Medicine

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Background: The additional benefits of certain frequently used chronic drugs such as statins or aspirin are investigated for their possible effect of influencing various types of cancer, including gastric cancer. The possible role of statins in the occurrence of pre-neoplastic gastric lesions has not been investigated. Aim: The study aims to determine the influence of chronic statin therapy on premalignant gastric lesions (glandular atrophy, intestinal metaplasia and dysplasia), adjusted with the most important aggressive environmental factors of the gastric mucosa (Helicobacter pylori [H. pylori] infection, low-dose aspirin [acetylsalicylic acid, ASA], biliary reflux, smoking, alcohol consumption). Method: The study included 566 patients with cardiovascular diseases who underwent an upper endoscopy: 222 patients with chronic statin therapy (atorvastatin 20–80 mg/day or rosuvastatin 5–20 mg/day for at least 6 months) and 344 patients without statin intake. A complete set of biopsies from the gastric antrum and corpus were routinely processed and examined, and demographical, clinical, and pathological variables were recorded. Results: Active H. pylori infection in gastric biopsies (p = 0.45), biliary reflux (p = 0.74), alcohol consumption (p = 0.43), or prior ulcer disease (p = 0.07; OR: 0.59; 95% CI: 0.33–1.04) were not associated with an increased risk for premalignant lesions, neither in the statin, nor the no-statin group. Smoking was associated with premalignant lesions in both groups (p = 0.01; OR: 2.24; 95% CI: 1.12–4.47; and p = 0.04; OR: 1.72; 95% CI: 1.01–2.94, respectively), while chronic use of ASA had no influence (p = 0.24, respective p = 0.35). In multivariate regression models, chronic treatment with statins had a protective effect (p = 0.006; OR: 0.59; 95% CI: 0.4–0.8), while smoking (p = 0.01; OR: 1.99; 95% CI: 1.17–3.39) and age >50 years (p <0.01, OR: 3.09; 95% CI: 1.84–5.21) were predictors for pre-neoplastic lesions. H. pylori infection, gender, alcohol consumption, biliary reflux, or prior ulcer disease were not associated with premalignant lesions (p >0.05). Conclusions: In the studied population, chronic statin treatment seems to be associated with a decreased risk for premalignant gastric lesions, while age over 50 years and smoking, regardless of gender or ASA consumption, remain the most important risk factors for premalignant gastric lesions.

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Do Statins Increase the Risk of Esophageal Conditions? Findings from Four Propensity Score-Matched Analyses

Abstract: Statin therapy was associated with higher odds of being diagnosed with esophagitis and gastroesophageal reflux disease/dyspepsia. Further study is warranted to elucidate the potential role of statins in these commonly diagnosed esophageal conditions.

Cited by 7 publications

References 42 publications

Statins and gastroesophageal reflux disease

Statins and gastroesophageal reflux disease

Role of Dietary and Lifestyle Modifications in the Secondary Prevention of Biomarkers of Plaque recurrence in Omani Coronary Revascularized Patients

Chronic Statin Therapy and Histologic Gastric Changes

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