Abstract
Background
Recent data suggest a reduction in the occurrence of venous thromboembolism in select
groups of patients who use statins. The objective of this study is to evaluate the
impact of statin use on the occurrence of venous thromboembolism in patients with
solid organ tumor.
Methods
We conducted a retrospective, case-control study reviewing 740 consecutive patients
with a diagnosis of solid organ tumor who were admitted to the Albert Einstein Medical
Center, Philadelphia, Penn, between October 2004 and September 2007. Patients treated
with anticoagulation therapy before their first admission were excluded. The occurrence
of venous thromboembolism, risk factors for venous thromboembolism, and statin use
were recorded. Patients who never used statins or had used them for less than 2 months
were relegated to the control group.
Results
The mean age of the study population was 65 years, and 52% of the patients were women
and 76% were African American. The occurrence of venous thromboembolism was 18% (N=132), and 26% (N=194) were receiving statins. Among patients receiving statins, 8% (N=16) developed a venous thromboembolism compared with 21% (N=116) in the control group (odds ratio 0.33; 95% confidence interval, 0.19-0.57). A
logistic regression analysis including risk factors for venous thromboembolism (metastatic
disease, use of chemotherapy, immobilization, smoking, and aspirin use) along with
statin use yielded the same results.
Conclusion
This study suggests that the use of statins is associated with a significant reduction
in the occurrence of venous thromboembolism. This pleiotropic effect warrants further
investigation.
Keywords
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References
- Phlegmasia alba dolens.Clin Med Hotel Dieu de Paris. 1865; 3: 94-96
- Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study.Arch Intern Med. 2000; 160: 809-815
- Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study.Arch Intern Med. 1998; 158: 585-593
- Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy.J Thromb Haemost. 2007; 5: 632-643
- Why might statins prevent venous thromboembolism: what needs to be done to know more?.Expert Opin Investig Drugs. 2002; 11: 1659-1668
- The atherogenic lipoprotein phenotype and vascular endothelial dysfunction.Atherosclerosis. 1998; 138: 229-235
- Altered megakaryocyte-platelet haemostatic axis in hypercholesterolemia.Platelets. 2001; 12: 292-297
- Lipoproteins and the hemostatic system in atherothrombotic disorders.Bailliere's Best Pract Res Clin Hematol. 1999; 12: 555-575
- Hypercholesterolemia as a risk factor for deep-vein thrombosis.Thromb Res. 1997; 88: 67-73
- Increased lipoprotein(a) is an important risk factor for venous thromboembolism in childhood.Circulation. 1999; 100: 743-748
- Increased lipoprotein(a) levels as an independent risk factor for venous thromboembolism.Blood. 2000; 96: 3364-3368
- Current perspectives on statins.Circulation. 2000; 101: 207-213
- Role of dyslipidemia and statins in venous thromboembolism.Curr Control Trials Cardiovasc Med. 2001; 2: 165-170
- The anti-thrombotic effects of statins.J Am Coll Cardiol. 1999; 33: 1305-1307
- Direct demonstration of anti-inflammatory effect of simvastatin in subjects with the metabolic syndrome.J Clin Endocrinol Metab. 2006; 91: 4489-4496
- Rosuvastatin to prevent vascular events in men and women with elevated C-Reactive protein.N Engl J Med. 2008; 359: 2195-2207
- A randomized trial of rosuvastatin in the prevention of venous thromboembolism.N Engl J Med. 2009; 360: 1851-1861
- Use of statins and the subsequent development of deep vein thrombosis.Arch Intern Med. 2001; 161: 1405-1410
- Postmenopausal hormone therapy increases risk for venous thromboembolic disease.Ann Intern Med. 2000; 132: 689-696
- The hypercoagulable state of malignancy: pathogenesis and current debate.Neoplasia. 2002; 4: 465-473
- Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients.Cancer. 2007; 110: 2339-2346
- Epidemiology and management of venous thromboembolism in patient with cancer.Thromb Res. 2003; 110: 167-172
- Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients.BMJ. 2002; 324: 71-86
- Effect of low-dose aspirin on the occurrence of venous thromboembolism: a randomized trial.Ann Intern Med. 2007; 147: 525-533
- Simvastatin reduces expression of cytokines interleukin-6, interleukin-8, and monocyte chemoattractant protein-1 in circulating monocytes from hypercholesterolemic patients.Atherioscler Thromb Vasc Biol. 2002; 22: 1194-1199
- Simvastatin reduces serum level of vascular endothelial growth factor in hypercholesterolemic patients.J Cardiovasc Pharmacol. 2006; 47: 30-36
- High-density lipoprotein and the risk of recurrence venous thromboembolism.Circulation. 2007; 115: 1609-1614
- Relation of characteristics of metabolic syndrome to short-term prognosis and effects of intensive statin therapy after acute coronary syndrome: an analysis of the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial.Diabetes Care. 2005; 28: 2508-2513
- Clinical impact of bleeding in patients taking oral anticoagulant therapy for venous thromboembolism: a meta-analysis.Ann Intern Med. 2003; 139: 893-900
- American Society of Clinical Oncology Guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer.J Clin Oncol. 2007; 25: 5490-5505
Article info
Footnotes
Funding: None.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.
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© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
