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BMJ Open. 2013 Nov 07;3(11):e003135. doi: 10.1136/bmjopen-2013-003135.

Statin treatment and risk of recurrent venous thromboembolism: a nationwide cohort study.

BMJ open

Cu Dinh Nguyen, Charlotte Andersson, Thomas Bo Jensen, Anne Gjesing, Anne-Marie Schjerning Olsen, Carolina Malta Hansen, Harry Büller, Christian Torp-Pedersen, Gunnar H Gislason

Affiliations

  1. Department of Cardiology, Gentofte Hospital, University of Copenhagen, Denmark.

PMID: 24202053 PMCID: PMC3822311 DOI: 10.1136/bmjopen-2013-003135

Abstract

OBJECTIVES: Statins may decrease the risk of primary venous thromboembolism (VTE), that is, deep vein thrombosis (DVT) and pulmonary embolism (PE) but the effect of statins in preventing recurrent VTE is less clear. The aim of this study was therefore to investigate the association between statin therapy and risk of recurrent VTE.

DESIGN: A prospective cohort study.

SETTING: All hospitals in Denmark.

PARTICIPANTS: All patients with a hospital diagnosis of VTE in Denmark during 1997-2009 associated with a warfarin or heparin prescription were identified.

MAIN OUTCOME MEASURES: Adjusted HR of recurrent hospitalised VTE (ie, fatal or non-fatal DVT or PE) associated with use of statins.

RESULTS: 44 330 patients with VTE were included in the study. Of these 3914 were receiving statin therapy at baseline. Patients receiving statins were older (68±11 compared to 62±18 years), had more comorbidity and used more medications. The incidence rate for recurrent VTE was 24.4 (95% CI 22.8 to 26.2) per 1000 person-years among statin users and 48.5 (95% CI 47.4 to 49.7) per 1000 person-years among non-statin users. Statin use was associated with a significantly lower risk of a recurrent VTE, adjusted HR 0.74 (95% CI 0.68 to 0.80), compared with no statin use. The association between statin use and risk of recurrent VTE was significantly affected by age. Among younger individuals (≤80 years), statin use was associated with lower risk of recurrent VTE, HR 0.70 (95% CI 0.65 to 0.76) whereas in older individuals (>80 years) statin use was significantly associated with higher risk of recurrent VTE, HR 1.28 (95% CI 1.02 to 1.60), p for interaction=<0.0001.

CONCLUSIONS: Statin use was associated with a decreased risk of recurrent VTE.

Keywords: EPIDEMIOLOGY; VASCULAR MEDICINE

References

  1. J Thromb Haemost. 2004 May;2(5):718-25 - PubMed
  2. J Thromb Haemost. 2004 May;2(5):700-1 - PubMed
  3. J Clin Epidemiol. 2006 Mar;59(3):265-73 - PubMed
  4. Br J Clin Pharmacol. 1997 Apr;43(4):429-33 - PubMed
  5. Thromb Res. 2012 Dec;130(6):859-63 - PubMed
  6. J Clin Epidemiol. 2002 May;55(5):525-30 - PubMed
  7. JAMA. 2005 May 18;293(19):2352-61 - PubMed
  8. J Clin Epidemiol. 2006 Aug;59(8):819-28 - PubMed
  9. Scand J Public Health. 2011 Jul;39(7 Suppl):22-5 - PubMed
  10. Am J Epidemiol. 2007 Aug 1;166(3):348-54 - PubMed
  11. J Thromb Haemost. 2009 Apr;7(4):521-8 - PubMed
  12. PLoS Med. 2012;9(9):e1001310 - PubMed
  13. Eur Heart J. 2006 May;27(10):1153-8 - PubMed
  14. Acta Neurol Scand. 2012 Mar;125(3):213-7 - PubMed
  15. Circulation. 2008 Jan 1;117(1):93-102 - PubMed
  16. JAMA. 2012 Nov 28;308(20):2118-25 - PubMed
  17. Eur Heart J. 2013 Jun;34(24):1800-6 - PubMed
  18. Arch Intern Med. 2001 Jun 11;161(11):1405-10 - PubMed
  19. J Clin Epidemiol. 2003 Feb;56(2):124-30 - PubMed
  20. Heart. 2012 Dec;98(24):1817-21 - PubMed
  21. Ann Intern Med. 2000 May 2;132(9):689-96 - PubMed
  22. Eur J Vasc Endovasc Surg. 2003 Jan;25(1):1-5 - PubMed
  23. J Clin Epidemiol. 2010 Feb;63(2):223-8 - PubMed
  24. Am J Cardiol. 2005 Sep 5;96(5A):11F-23F - PubMed
  25. N Engl J Med. 2012 May 24;366(21):1959-67 - PubMed
  26. Epidemiology. 2013 Jul;24(4):619-20 - PubMed
  27. Eur Heart J. 2010 May;31(10):1248-56 - PubMed
  28. Thromb Res. 2008;122(3):314-9 - PubMed
  29. Arterioscler Thromb Vasc Biol. 2005 Feb;25(2):287-94 - PubMed
  30. Arterioscler Thromb Vasc Biol. 2005 Jul;25(7):1524-5 - PubMed
  31. Circulation. 2001 May 8;103(18):2248-53 - PubMed
  32. Circulation. 2013 Jan 15;127(2):251-7 - PubMed
  33. N Engl J Med. 2009 Apr 30;360(18):1851-61 - PubMed
  34. Scand J Public Health. 2011 Jul;39(7 Suppl):30-3 - PubMed
  35. J Thromb Thrombolysis. 2006 Feb;21(1):23-9 - PubMed
  36. Scand J Public Health. 2011 Jul;39(7 Suppl):38-41 - PubMed
  37. Arterioscler Thromb Vasc Biol. 2007 Mar;27(3):690-6 - PubMed
  38. J Thromb Haemost. 2009 Apr;7(4):514-20 - PubMed
  39. Scand J Public Health. 2011 Jul;39(7 Suppl):26-9 - PubMed
  40. N Engl J Med. 1974 Jan 3;290(1):15-9 - PubMed

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