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Thromboembolic Disease I


Wednesday, November 4, 2009

12:45 PM - 2:00 PM

STATIN USE MAY REDUCE THE OCCURRENCE OF VENOUS THROMBOEMBOLISM: A STUDY IN PATIENTS WITH ATHEROSCLEROTIC DISEASE

Danai Khemasuwan, MD*, Young K. Chae, MD, Stafan V. Neagu, MD, Shrika Gupta, MD, Alejandra Carpio, MD and Jorge Mora, MD

Albert Einstein Medical Center, Philadelphia, PA

PURPOSE: Atherosclerosis and venous thromboembolism (VTE) may share common pathophysiology based on common inflammatory mediators. Statins therapy showed substantial benefit in atherosclerosis, but the effect of statins in venous thromboembolism is still controversial. The objective of this study is to investigate the association between the use of statins in patients with history of atherosclerosis on the occurrence of VTE.

METHODS: We conducted a retrospective, case-control study, reviewing 593 patients admitted to Albert Einstein Medical Center (AEMC), Philadelphia with a diagnosis of either myocardial infarction or ischemic stroke. Patients who had been treated with anticoagulation therapy before the first visit at AEMC were excluded. The occurrence of VTE, risk factors for VTE, and use of statins were recorded. The patients who either used statins for less than 2 months or never used statins were allocated to the nonuser group.

RESULTS: The mean age of the entire study population was 67.8 years. 52% of the patients were female and 77% were African American. The overall incidence of VTE was 13%; and 73% (N = 433) were on statins. Among patients on statins, 8.3 % (36/433) developed a VTE, compared to 26.3% (42/160) in the nonuser group [OR (Odd ratio), 0.25; 95% CI, 0.16 –0.42; P < 0.001]. Even after controlling for factors related to VTE (smoking, history of cancer, and immobilization), statins use was still associated with low risk of developing VTE [OR, 0.27; 95% CI, 0.16–0.44; P < 0.001]. Furthermore, high dose statins use (greater than 40 mg/day) [OR, 0.32; 95% CI, 0.12 –0.82; P = 0.017] showed lower occurrence of VTE compared to standard dose statins [OR, 0.48; 95% CI, 0.29–0.78; P = 0.003].

CONCLUSION: In this study, the use of statins appears to be associated with a significant reduction in the occurrence of VTE with a dose-related response. This possible protective effect of statins warrants further investigation.

CLINICAL IMPLICATIONS: The use of statins may help to prevent venous thromboembolism in patients with atherosclerotic diseases.

DISCLOSURE: Danai Khemasuwan, No Financial Disclosure Information; No Product/Research Disclosure Information







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