Statins for Primary Prevention of Variceal Bleeding in Cirrhosis: A Scoping Review

Background/Objectives: Variceal bleeding (VB) is a major complication of cirrhosis, marking a progression from a compensated to a decompensated stage of the disease. Previous research has suggested that HMG-CoA reductase inhibitors, commonly called statins, may have therapeutic benefits for those living with cirrhosis, though their exact benefits and role have yet to be elucidated. This scoping review evaluates the potential role of statins in the primary prevention of variceal bleeding in patients with cirrhosis, and if there exists a difference between hydrophilic and lipophilic statins for this indication. Methods: Publications from the last 10 years with primary or secondary outcomes reporting variceal bleeding among statin users and non-users were included. A search via PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library was conducted, identifying nine studies. Results: Findings related to the benefit of statin use for the prevention of variceal bleeding were inconsistent among study designs. Retrospective studies suggest a lower incidence of VB among statin users compared to non-users. However, this finding has not been borne out in prospective studies. Conclusions: Given the conflicting findings, there is insufficient evidence at present to suggest the routine use of statins for the prevention of variceal bleeding in patients with cirrhosis.