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Statin use linked to decreased risk for recurrent venous thrombosis
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Statin use appeared to decrease risk for recurrent venous thrombosis in patients who had experienced an incident venous thrombosis, according to the results of a population-based cohort study.
Venous thrombosis commonly recurs in adults who experience an incident event within the first year following anticoagulation therapy.
“While anticoagulation therapy is effective at preventing thrombotic recurrences, the substantial bleeding risk with long-term treatment limits its use to patients with a moderate or high risk for recurrence,” Nicholas L. Smith, PhD, professor in the department of epidemiology at the University of Washington, and colleagues wrote. “The search for alternative treatments that lower the recurrence potential, ideally without increasing the risk for bleeding, is critical to improved clinical management.”
Smith and colleagues evaluate whether statins reduced risk for recurrent venous thrombosis.
“Based on the evidence from the primary prevention setting, we hypothesized that statin therapy reduces the risk [for] a recurrent venous thrombosis and that risk reduction is greatest among those without clinical cardiovascular disease,” researchers wrote.
Researchers used medical records from the Group Health Collective in Washington to evaluate data from 2,798 patients (mean age, 65.8 years; 55% women) who experienced a venous thrombosis (53% pulmonary embolism) incident between 2002 and 2010. Of these patients, 204 (7.3%) died within 30 days of the venous thrombosis incident.
At baseline, 22.1% of patients received lipid-lowering treatments (98.7% statins) and 24% had cardiovascular disease.
Median follow-up was 3.4 years (range, 0-11). During that time, 16% (n = 457) of patients developed a recurrent venous thrombosis, 39% of which included a PE. Seven percent of patients developed cardiovascular disease, and 21% initiated treatment with statins. Of patients treated with statins at baseline, 27% stopped during follow-up; overall, 38% of the cohort used statins at some point during follow-up.
Rate of venous thrombosis recurrence was 5.2 (95% CI, 4.7-5.9) per 100 person-years among statin nonusers and 3.9 (95% CI, 3.3-4.7) per 100 person-years among current statin users.
Current use of statin therapy appeared to decrease risk for recurrent venous thrombosis (HR = 0.74; 95% CI, 0.59-0.94). This association persisted when researchers analyzed patients who began statin use during follow-up (HR = 0.62; 95% CI, 0.41-0.93) and patients who did not have cardiovascular disease (HR = 0.62; 95% CI, 0.45-0.85).
Researchers observed a clinically relevant risk reduction across statin types and dosages, especially with use of simvastatin (HR = 0.76; 95% CI, 0.57-1).
Researchers acknowledge that the nonrandomized nature of the statin-use data may have confounded the findings.
“There is evidence that statins reduce proinflammatory cytokines and procoagulation hemostatic factors, leading to improved endothelial function and lower thrombotic risk,” Smith and colleagues wrote. “The magnitude of the association found in our study is similar to the estimated effect of aspirin on recurrent venous thrombosis and appears clinically relevant.” – by Nick Andrews
Disclosure: Smith reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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