S2819 A Meta-Analysis About the Efficacy of Statins on Hepatic Venous Pressure Gradient (HVPG) in Cirrhosis Disease

Introduction: Portal hypertension is a common consequence in cirrhosis and can cause variceal bleeding, ascites and hepatic encephalopathy. It is defined as elevation of hepatic venous pressure gradient (HVPG) >5 mmHg. Statins may enhance HVPG in patients with liver cirrhosis (LC). This meta-analysis aimed to assess the impact of statins use on HVPG among patients suffering from LC. Methods: We systematically searched 7 databases to extract relevant papers. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess the risk of bias for randomized controlled trials. The statistical analyses were carried out using Comprehensive Meta-Analysis version 3 (Biostat Inc., USA). Standard mean difference (SMD) with 95% confidence intervals (CIs) was calculated for hepatic venous pressure gradient using random effects. Results: The literature search found 7 randomized controlled trials (RCT). Among the included studies, 2 were regarded as having a high risk of bias, while one study presented some concerns. However, 4 studies were rated as having a low risk of bias. Our results showed that statin treatment could significantly decrease the value HVPG comparing with control group (SMD: -0,613; 95% CI: -1,179 to -0,046; P = 0,034) as presented by the forest plot analysis. However, a high heterogeneity was detected among studies: Chi2 = 34,28, P = 0,000, I2 = 82%. Conclusion: This meta-analysis suggested that statins decreased HVPG and improved liver function in patients with cirrhosis. But the beneficial effects of statins should be confirmed in long-term clinical trials for portal hypertension.