Key result
Statin therapy was not significantly associated with a reduced overall risk of recurrent venous thromboembolism, but demonstrated a 50% risk reduction during periods without anticoagulation.
Why the study?
Prior studies noted lower rates of recurrent VTE among statin users, but this could be influenced by concurrent anticoagulation and confounding by indication.
Does statin therapy reduce recurrent venous thromboembolism in elderly patients with acute VTE?
Cohort (n=980)
Yes
Does statin therapy reduce recurrent venous thromboembolism in elderly patients with acute VTE?
Effect estimate: aSHR 0.72 (95% CI 0.44 to 1.19)
Absolute Event Rate: 8.7% vs 13.4%
p-value: p=0.20
Statin use is associated with a pronounced risk reduction for recurrent VTE in elderly patients, specifically during periods without concurrent anticoagulation.
Statin use may lower recurrent VTE risk off anticoagulation in elderly patients; leaves open overall benefit pending randomized confirmation.
Previous studies reported lower rates of recurrent venous thromboembolism (rVTE) among statin users, but this association could be influenced by concurrent anticoagulation and confounding by statin indication. This study aimed to confirm the beneficial association between statins and rVTE, stratified according to periods with and without anticoagulation, and additionally employ propensity score weighted approach to reduce risk of confounding by indication. The setting was a prospective multicentre cohort study and the outcome was time to first rVTE in statin vs. non-statin users. 980 participants with acute VTE were enrolled (mean age 75.0 years, 47% women), with median follow-up of 2.5 years. Of 241 (24.3%) statin users, 21 (8.7%) suffered rVTE vs. 99 (13.4%) among 739 non-users. The overall adjusted sub-hazard ratio (aSHR) for rVTE comparing statin users to non-users was 0.72 (95%CI 0.44 to 1.19, p = 0.20). This association was only apparent during periods without anticoagulation (aSHR 0.50, 95%CI 0.27 to 0.92, p = 0.03; vs. with anticoagulation: aSHR 1.34, 95%CI 0.54 to 3.35, p = 0.53). Using propensity scores, the rVTE risk during periods without anticoagulation fell further (aSHR 0.20, 95%CI 0.08 to 0.49, p < 0.001). In conclusion, statin use is associated with a more pronounced risk reduction for rVTE than previously estimated, but only during periods without anticoagulation.
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Kronenberg et al. (2019) conducted a cohort in Acute venous thromboembolism (n=980). Statin therapy vs. No statin therapy was evaluated on Time to first recurrence of symptomatic, objectively confirmed VTE (rVTE) (aSHR 0.72, 95% CI 0.44 to 1.19, p=0.20). Statin therapy was not significantly associated with a reduced overall risk of recurrent venous thromboembolism, but demonstrated a 50% risk reduction during periods without anticoagulation.
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