The association of statin therapy with the risk of recurrent venous thrombosis

Smith, N L; Harrington, L B; Blondon, Marc; Wiggins, K L; Floyd, J S; Sitlani, C M; McKnight, B; Larson, E B; Rosendaal, F R; Heckbert, S R; Psaty, B M

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Title		The association of statin therapy with the risk of recurrent venous thrombosis
Authors		Smith, N L Harrington, L B Blondon, Marc Wiggins, K L Floyd, J S Sitlani, C M McKnight, B Larson, E B Rosendaal, F R Heckbert, S R Psaty, B M show all authors [1 - 11]
Published in		Journal of Thrombosis and Haemostasis. 2016, vol. 14, no. 7, p. 1384-1392
Abstract		Background Meta-analyses of randomized controlled trials suggest that treatment with hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) lowers the risk of incident venous thrombosis (VT), particularly among those without prevalent clinical cardiovascular disease (CVD). Whether this is true for the prevention of recurrent VT is debated. We used an observational inception cohort to estimate the association of current statin use with the risk of recurrent VT. Methods and Results The study setting was a large healthcare organization with detailed medical record and pharmacy information at cohort entry and throughout follow-up. We followed 2798 subjects 18-89 years of age who experienced a validated incident VT between January 1, 2002, and December 31, 2010, for a first recurrent VT, validated by medical record review. During follow-up, 457 (16%) developed a first recurrent VT. In time-to-event models incorporating time-varying statin use and adjusting for potential confounders, current statin use was associated with a 26% lower risk of recurrent VT: hazard ratio 0.74, 95% confidence interval 0.59-0.94. Among cohort members free of CVD (n = 2134), current statin use was also associated with a lower risk (38%) of recurrent VT: hazard ratio 0.62, 95% confidence interval 0.45-0.85. We found similar results when restricting to new users of statins and in subgroups of different statin types and doses. Conclusions In a population-based cohort of subjects who had experienced an incident VT, statin use, compared with nonuse, was associated with a clinically relevant lower risk of recurrent VT. These findings suggest a potential secondary benefit of statins among patients who have experienced an incident VT.
Identifiers		DOI: 10.1111/jth.13334 PMID: 27061794
Full text		Article (Published version) (190 Kb) - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine interne des spécialités
Research group		La maladie thromboembolique veineuse (808)
Citation (ISO format)		SMITH, N L et al. The association of statin therapy with the risk of recurrent venous thrombosis. In: Journal of Thrombosis and Haemostasis, 2016, vol. 14, n° 7, p. 1384-1392. https://archive-ouverte.unige.ch/unige:89068