Chronic use of statins and acetylsalicylic acid and incidence of post-endoscopic retrograde cholangiopancreatography acute pancreatitis: A multicenter, prospective, cohort study.

Published on May 1, 2021in Digestive Endoscopy4.774
· DOI :10.1111/DEN.13801
Karina Cárdenas-Jaén5
Estimated H-index: 5
Livia Archibugi13
Estimated H-index: 13
(UniSR: Vita-Salute San Raffaele University)
+ 22 AuthorsEnrique de-Madaria18
Estimated H-index: 18
OBJECTIVES post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis (PEP) is a frequent complication of this endoscopic procedure. Chronic statin intake has been linked to lower incidence and severity of acute pancreatitis (AP). Periprocedural rectal administration of non-steroidal anti-inflammatory drugs is protective against PEP, but the role of chronic acetylsalicylic-acid (ASA) treatment is unclear. We aimed to investigate whether statins and chronic ASA intake are associated with lower risk of PEP. METHODS an international, multicenter, prospective cohort study. Consecutive patients undergoing ERCP in seven european centers were included. Patients were followed-up to detect those with PEP. Multivariate analysis by means of binary logistic regression was performed, and adjusted odds ratios (aORs) were calculated. RESULTS a total of 1,150 patients were included, and 70 (6.1%) patients developed PEP. Among statins users, 8.1% developed PEP vs. 5.4% among non-users (p = 0.09). Multivariate analysis showed no association between statin use and PEP incidence (aOR 1.68 (95% CI 0.94-2.99, p = 0.08). Statin use had no effect on severity of PEP, being mild in 92.0% of statin users vs. 82.2% in non-statin users (p = 0.31). Chronic ASA use was not associated with PEP either (aOR 1.02 (95% CI 0.49-2.13), p = 0.96). Abuse of alcohol and previous endoscopic biliary sphincterotomy were protective factors against PEP, while >1 pancreatic guidewire passage, normal bilirubin values, and duration of the procedure >20 minutes, were risk factors. CONCLUSIONS the use of statins or ASA is not associated with a lower risk or a milder course of PEP.
📖 Papers frequently viewed together
5 Authors (Yousaf Hadi, ..., John Nasr)
2 Citations
16 Citations
5 Citations
#1Ryunosuke HakutaH-Index: 9
#2Yousuke NakaiH-Index: 51
Last. Kazuhiko KoikeH-Index: 91
view all 17 authors...
GOALS AND BACKGROUND: Endoscopic retrograde cholangiopancreatography is widely utilized to diagnose and treat various pancreaticobiliary diseases, but postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) can be a fatal adverse event. Evidence suggests that statins may exhibit suppressive effects on inflammation in the pancreas. We carried out an observational cohort study to examine the protective effect of statins on PEP. STUDY: We retrospectively identified consecutive patient...
4 CitationsSource
Last. Enrique de-MadariaH-Index: 18
view all 9 authors...
Abstract Background The most frequent complication of endoscopic retrograde cholangiopancreatography (ERCP) is post-ERCP acute pancreatitis (PEP). Statin consumption seems to lower the incidence of acute pancreatitis. We aimed to investigate the relationship between the use of statins and the incidence of PEP. Methods multicenter (4 Spanish tertiary-level public hospitals) retrospective cohort study. Adult patients undergoing an ERCP were included in the study. We excluded patients with chronic ...
2 CitationsSource
#1Jean-Marc DumonceauH-Index: 75
#2Christine KapralH-Index: 2
Last. Jeanin E. van Hooft (UvA: University of Amsterdam)H-Index: 41
view all 15 authors...
Prophylaxis 1 ESGE recommends routine rectal administration of 100 mg of diclofenac or indomethacin immediately before endoscopic retrograde cholangiopancreatography (ERCP) in all patients without contraindications to nonsteroidal anti-inflammatory drug administration. Strong recommendation, moderate quality evidence. 2 ESGE recommends prophylactic pancreatic stenting in selected patients at high risk for post-ERCP pancreatitis (inadvertent guidewire insertion/opacification of the pancreatic duc...
57 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Vincenzo Rosario Buccino (University of Foggia)H-Index: 7
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
view all 6 authors...
ABSTRACT Background Basic and clinical studies suggest that statins may prevent and even ameliorate acute pancreatitis. The present study was to evaluate whether statin decreases the risk of acute pancreatitis in patients undergoing endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts. Methods Out of 456 patients with pancreatic cysts referred to our center between 2006 and 2018, 365 were finally included in analyses: 86 were treated with statins and 279 were not at the time o...
5 CitationsSource
#1Nadav Sahar (Virginia Mason Medical Center)H-Index: 8
#2Andrew S. Ross (Virginia Mason Medical Center)H-Index: 25
Last. Paul R. TarnaskyH-Index: 20
view all 15 authors...
BACKGROUND AND AIM: Pancreatic plastic stents (PPS) can reduce the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Prospective multicenter documentation of PEP rate after PPS placement is scarce. A new 4-Fr stent designed to be deployed over a 0.035-inch guidewire was used to assess the effectiveness of PEP prophylaxis. METHODS: High-PEP-risk patients received a 4-Fr PPS for primary or secondary prophylaxis at seven centers in four countries. Patients were followe...
2 CitationsSource
#1Frank Ulrich WeissH-Index: 23
#2Felix LaemmerhirtH-Index: 2
Last. Markus M. LerchH-Index: 102
view all 3 authors...
Based on the recognition of common etiological and genetic risk factors, acute and chronic pancreatitis are increasingly regarded as a continuum of the same disease, with a significant overlap of clinical manifestations and phenotypes but distinct morphological and imaging appearances. Recent population-based and cohort studies have found that tobacco smoke conveys a greater risk than immoderate alcohol consumption for the development of chronic pancreatitis, and hypertriglyceridemia has been id...
8 CitationsSource
#1Anne F. Peery (UNC: University of North Carolina at Chapel Hill)H-Index: 23
#2Seth D. Crockett (UNC: University of North Carolina at Chapel Hill)H-Index: 28
Last. Robert S. Sandler (UNC: University of North Carolina at Chapel Hill)H-Index: 103
view all 17 authors...
Background & Aims Estimates of disease burden can inform national health priorities for research, clinical care, and policy. We aimed to estimate health care use and spending among gastrointestinal (GI) (including luminal, liver, and pancreatic) diseases in the United States. Methods We estimated health care use and spending based on the most currently available administrative claims from commercial and Medicare Supplemental plans, data from the GI Quality Improvement Consortium Registry, and na...
341 CitationsSource
#1Taija Korpela (UH: University of Helsinki)H-Index: 4
Last. Enrique de-MadariaH-Index: 18
view all 10 authors...
Abstract Background Acute pancreatitis (AP) is the most common complication after endoscopic retrograde cholangiopancreatography (ERCP). Statins have been traditionally associated to an increased risk of AP, however, recent evidence suggests that statins may have a protective role against this disease. Aims Our primary aim is to investigate whether the use of statins has a protective effect against post-ERCP pancreatitis (PEP). Secondary outcomes are: to evaluate the effect of other drugs on the...
4 CitationsSource
#1Yunxiao LyuH-Index: 6
#2Yunxiao ChengH-Index: 6
Last. Weibing DuH-Index: 3
view all 5 authors...
Background Recently, although studies have investigated the role of NSAIDs in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP), selection of the ideal drug, the time and route of its administration for the appropriate population remain controversial.
17 CitationsSource
#1Mahmud Mahamid (Nazareth Hospital EMMS)H-Index: 16
#2Abdulla Watad (TAU: Tel Aviv University)H-Index: 25
Last. Eran GoldinH-Index: 36
view all 9 authors...
Background and aims: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is one of the major complications of ERCP. Thus, several non-invasive as well as invasive strategies have been investigated as preventative therapies for PEP with various efficacy. Methods: We enrolled any patients who underwent ERCP both at the Shaare Zedek Medical Center in Jerusalem and EMMS Nazareth hospital. Association between use of statins and different variables were assessed with univaria...
8 CitationsSource
Cited By1
#1Antonio Facciorusso (University of Foggia)H-Index: 19
Last. Luca BarresiH-Index: 22
view all 6 authors...
There is limited evidence on the role of chronic statin therapy in the prevention of acute pancreatitis after ERCP. The aim of this meta-analysis was to evaluate the efficacy of statins in the prop...
1 CitationsSource