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Statin therapy initiated in a man with hepatitis C and elevated cholesterol
The Clinical Advisor, 10/07/09
Friedrich DA – Coronary atherosclerosis is a major cause of morbidity and mortality in Western society. Deposition of cholesterol in arterial walls is central to the pathogenesis of the disease. Based on extensive research, aggressive treatment of dyslipidemia is standard practice, especially in such high–risk groups as patients with FH. Approximately 4.1 million Americans (1.6%) have antibody to HCV. Although clinically significant liver injury from statins is extremely rare, mild increases in liver enzymes can occur in 1%–3% of patients. Because of concerns about possible liver damage, statins are contraindicated in patients with liver disease. In Mr. F's case, the benefit of statin therapy outweighed the risk. Statin treatment is essential to reduce the profound morbidity and mortality associated with FH. Current studies have looked at the safety of statins in patients with established liver disease and suggested that these medications are safe (perhaps even beneficial) in patients with compensated liver disease.
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