Key result
Rosuvastatin adjuvant therapy significantly reduced the occurrence of post thrombotic syndrome following deep vein thrombosis compared to anticoagulants alone (p<0.0001).
Why the study?
Statins have anticoagulation and anti-inflammatory effects, prompting investigation into the effect of rosuvastatin on reducing post thrombotic syndrome following deep vein thrombosis.
Does rosuvastatin added to anticoagulation reduce the prevalence of post thrombotic syndrome in patients with lower extremity deep vein thrombosis?
RCT (n=182)
randomly assigned
Does rosuvastatin added to anticoagulation reduce the prevalence of post thrombotic syndrome in patients with lower extremity deep vein thrombosis?
p-value: p=<0.0001
Adjuvant therapy with rosuvastatin for 3 months in patients with lower extremity DVT significantly reduces the incidence of post thrombotic syndrome and inflammatory markers.
Adjuvant rosuvastatin lowers PTS incidence after DVT; extends evidence for statin pleiotropy in venous thromboembolism.
Introduction: Statins are known to have anticoagulation and anti-inflammatory effects. This study aimed to investigate the effect of Rosuvastatin in reduction of post thrombotic syndrome (PTS) following deep vein thrombosis (DVT). Methods: In this randomized clinical trial, patients who were diagnosed with DVT of lower extremity were randomly assigned to 4 treatment groups: group 1: Warfarin, group 2: Warfarin + Rosuvastatin, group 3: Rivaroxaban, and group 4: Rivaroxaban + Rosuvastatin. The treatments were followed for 3 months and prevalence of PTS (as primary outcome), as well as the changes in serum levels of D-dimer and C reactive protein (CRP), and the extent of thrombosis before and after the intervention (as secondary outcomes) were compared between groups. Results: 182 patients with the mean age of 55.22 ± 4.1 years finished the trial period (51.64% male). There was no significant difference between the groups regarding the baseline characteristics. Based on the Brandjes score, 31 (17.03%) patients had PTS at the end of the study. The occurrence of PTS was significantly lower in the groups taking statins (p<0.0001). Although the change in the mean difference of legs circumference before and after intervention, were significant in all groups (p < 0.05), the differences was more prominent in groups 2 and 4 (p < 0.0001). After 3 months of taking medication, decrease of CRP was more prominent in the statin groups (p = 0.001), and most cases with normal CRP were in statin groups. Among the patients with the serum D-dimer level above 10000 ng/mL, patients in the statin groups experienced significantly more reduction in D-dimer levels than the other groups (p<0.001). Conclusion: Rosuvastatin administration in combination with rivaroxaban or warfarin significantly reduces the level of inflammatory factors including CRP and D-dimer, compared to patients receiving anticoagulants alone. Rosuvastatin administration can significantly reduce the incidence of PTS and cause a difference in the size of the lower limbs within 3 months.
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Pishgahi et al. (2023) conducted an RCT in Deep vein thrombosis (DVT) of lower extremity (n=182). Rosuvastatin vs. Anticoagulants alone (Warfarin or Rivaroxaban) was evaluated on Prevalence of post thrombotic syndrome (PTS) (p=<0.0001). Rosuvastatin adjuvant therapy significantly reduced the occurrence of post thrombotic syndrome following deep vein thrombosis compared to anticoagulants alone (p<0.0001).
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