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Statin therapy and recurrent venous thromboembolism in the elderly: a prospective cohort study.

  • Kronenberg RM Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Beglinger S Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. shanthi.beglinger@extern.insel.ch.
  • Stalder O CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
  • Méan M Department of Medicine, Division of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
  • Limacher A CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
  • Beer JH Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland.
  • Aujesky D Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Rodondi N Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Feller M Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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  • 2019-10-17
Published in:
  • Scientific reports. - 2019
Aged
Aged, 80 and over
Anticoagulants
Case-Control Studies
Confounding Factors, Epidemiologic
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Incidence
Male
Prospective Studies
Recurrence
Secondary Prevention
Treatment Outcome
Venous Thromboembolism
English 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.
Language
  • English
Open access status
gold
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Persistent URL
https://sonar.ch/global/documents/284650
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