Is there an association between lipid-lowering drugs and cholecystectomy?

This study used population-based health-care databases to investigate the association between fibrate use and cholecystectomy compared with statins and a cardiovascular drug control group in older patients. A retrospective cohort of individuals 65 years of age and older was generated using the Ontario Drug Benefits database, for the period July 1, 1993 to March 31, 1998. Patients were included if they were prescribed any fibrates, statins, or long-acting dihydropyridine calcium-channel blockers. Calcium-channel blockers were selected as the control group since they are not known to affect biliary cholesterol saturation. The primary outcome measured was incidence of cholecystectomy. Relative to the calcium-channel blocker group, patients in the fibrate group were 50% more likely to undergo cholecystectomy. In contrast, patients in the statin group were significantly less likely to do so. Patients taking fibrates were also at a significantly greater risk of undergoing cholecystectomy relative to statin users. The findings of the study suggest that the newer fibrates continue to be associated with an increased risk of cholecystectomy. The apparent protective effect of statins requires further evaluation.