From the Research
Rosuvastatin is the statin that affects liver enzymes the least, as evidenced by a recent study showing that atorvastatin treatment was associated with a higher risk of 1-year all-cause mortality than rosuvastatin in patients with elevated liver enzymes following acute myocardial infarction 1. When considering the impact of statins on liver enzymes, it's essential to evaluate the available evidence and prioritize the most recent and highest quality studies.
- The study published in 2025 1 provides the most up-to-date and relevant information on this topic, demonstrating the superiority of rosuvastatin over atorvastatin in patients with elevated liver enzymes.
- Other studies, such as those published in 2018 2 and 2013 3, provide additional context and support the notion that statins can be safely used in patients with liver disease, but they do not directly compare the effects of different statins on liver enzymes.
- The older studies, such as those published in 2015 4, 2011 5, provide general information on the safety and efficacy of statins in patients with liver disease, but they do not offer specific guidance on the comparative effects of different statins on liver enzymes. Key points to consider when prescribing statins to patients with liver disease include:
- Baseline liver function tests and regular monitoring to detect any potential liver enzyme elevations
- Selection of a statin with a lower risk of liver enzyme elevations, such as rosuvastatin
- Dose adjustment and careful monitoring in patients with severe liver disease
- Consideration of potential drug interactions and careful selection of concomitant medications.