engleski

Chronic use of statins and acetylsalicylic acid and incidence of post-ERCP acute pancreatitis: a multicenter, prospective, cohort study

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.

endoscopic retrograde cholangiopancreatography ; hydroxymethylglutaryl-CoA reductase inhibitors ; pancreatitis ; prevention ; salicylates

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