Key result
Current statin use was associated with lower plasma levels of Factor XI compared to fibrate or niacin use.
Why the study?
Statins are a potential treatment for venous thromboembolism prophylaxis without associated bleeding complications, but comparisons of pro-thrombotic activities across different lipid-lowering drug classes were needed.
Does statin use reduce pro-coagulant factor levels compared to fibrate/niacin use in adults taking lipid-lowering drugs?
Cross-Sectional (n=1,043)
Does statin use reduce pro-coagulant factor levels compared to fibrate/niacin use in adults taking lipid-lowering drugs?
Current statin use is associated with lower plasma levels of coagulation factor XI compared to fibrate/niacin use, which may partly explain their potential benefit in venous thromboembolism prevention.
Answers are grounded in this paper and cite their sources.
Statin-associated Factor XI reduction is hypothesis-generating for VTE benefit; should not alter lipid-lowering choices pending trials.
BACKGROUND: Statins are a potential treatment for venous thromboembolism (VTE) prophylaxis complementary to conventional anticoagulants without associated bleeding complications. This study aimed to compare pro-thrombotic activities of different classes of lipid-lowering drugs in an active comparator design and determine whether there is a relation between statin versus fibrate/niacin use and pro-coagulant factor outcomes. METHODS: This is a cross-sectional analysis of participants from the Netherlands Epidemiology of Obesity study using any class of lipid-lowering drugs, including any types of statins, niacin, and fibrates. We performed linear regression analyses to determine fibrinogen, factor (F) VIII, FIX, and FXI activity in statins versus fibrate/niacin users and adjusted for age, sex, tobacco smoking, body mass index (BMI), hypertension, diabetes, and prevalent cardiovascular disease. Clinical characteristics were balanced between statin and fibrate/niacin users. Statin users had lower mean FXI (18.3 IU/dL, 95% confidence interval (CI) 9.4 to 27.3) levels compared to fibrate/niacin users. The level of FVIII (15.8 IU/dL, 95% CI - 0.003 to 31.6), and FIX (11.3 IU/dL, 95% CI - 0.4 to 23.2) were lower in statin users than fibrate/niacin users with marginal statistical significance. CONCLUSION: Current statin use was associated with lower plasma levels of FXI than fibrate/niacin use. The effects on coagulation factors may, in part, explain the benefit of statin therapy rendered in primary and secondary prevention of VTE.
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Bordbar et al. (2021) conducted a cross-sectional in Dyslipidemia (lipid-lowering drug users) (n=1,043). Statin use vs. Fibrate or niacin use was evaluated on Plasma levels of Factor XI (FXI) activity (MD -18.3 IU/dL, 95% CI -27.3 to -9.4). Current statin use was associated with lower plasma levels of Factor XI compared to fibrate or niacin use.
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