While serious liver injury among statin users is extremely rare, baseline liver enzyme testing is still recommended prior to initiating therapy. The benefit of such screening should be reevaluated based on empirical evidence. This study compared the risk of severe acute liver injury (SALI) between statin initiators with an elevated ALT (> 35U/L) matched to statin initiators with a normal ALT level (≤ 35U/L). Statin initiators with an elevated ALT were additionally compared against matched non-users.
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