Statin use and risk of recurrent venous thrombosis: results from the MEGA follow‐up study

Brækkan, Sigrid Kufaas; Caram‐Deelder, Camila; Siegerink, Bob; Vlieg, Astrid van Hylckama; Cessie, Saskia le; Rosendaal, Frits R.; Cannegieter, Suzanne C.; Lijfering, Willem M.

doi:10.1002/rth2.12003

Cited by 14 publications

(9 citation statements)

References 33 publications

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“…Approximately 25% ( n = 97) of all medication regimens for the patients in our study included a statin. A study among 170,459 cancer patients compared the effect of a statin on deep vein thrombosis, finding no difference in outcomes between statin use and no statin, 41 similar to our own observations.…”

Section: Discussionsupporting

confidence: 88%

Preoperative oncologic therapy and the prolonged risk of venous thromboembolism in resectable pancreatic cancer

et al. 2022

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Background: Pancreatic cancer is one of the most prothrombotic cancers.Among patients receiving preoperative chemotherapy followed by surgery, chemotherapy and surgery represent a compound risk for venous thromboembolism (VTE), rendering the postoperative time a period of interest. We aimed to analyze whether preoperative oncologic therapy increases the risk for VTE after surgery and identify which characteristics associate with VTE. Methods: We first identified patients surgically treated for pancreatic cancer at Helsinki University Hospital between 2000 and 2017, collecting the following data: gender, age at surgery, preoperative medication, body mass index (BMI), preoperative chemo(radio)therapy, tumor size, positive node ratio, perineural and perivascular invasion, tumor grade, surgical technique, postoperative anticoagulation, adjuvant therapy, time of VTE, time of local disease recurrence, time of distant metastasis, and time of death. With a follow-up period of at least 2 years or until death, we compared a total of 93 preoperative oncologic therapy and 291 upfront surgery patients (n = 384, median age 66.5 years).Results: Preoperative oncologic therapy increased the risk for thrombosis after surgery (hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.03-2.53). The VTE incidence rate remained high for up to 2 years after surgery. BMI ≥30 kg/m 2 , prior anticoagulation, and disease recurrence (p < 0.05, respectively) associated with VTE. VTE is also associated with shorter overall survival (HR 3.25;. In 71.6% (95% CI 60.5-81.1) of patients, VTE was diagnosed after disease recurrence. Conclusions:Preoperative oncologic therapy represents an independent risk factor for VTE, not only during the immediate postoperative period but up to 2 years after surgery. VTE is associated with obesity, prior anticoagulation, and disease recurrence and diminishes overall survival.

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Section: Discussionsupporting

confidence: 88%

Preoperative oncologic therapy and the prolonged risk of venous thromboembolism in resectable pancreatic cancer

et al. 2022

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“…A growing body of evidence indicates that statins are a promising treatment for VTE prophylaxis complementary to anticoagulants without associated bleeding complications [ 3 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Differential effect of statin use on coagulation markers: an active comparative analysis in the NEO study

et al. 2021

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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. Results Among 1043 participants, the mean age was 58.4 ± 5.2 years, 61% were men, and the mean BMI was 31.3 ± 4.5 kg/m2. 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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“…There is a growing body of evidence indicating that statins are a promising treatment for VTE prophylaxis complementary to anticoagulants without associated bleeding complications [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Differential effect of statin use on coagulation markers: an active comparative analysis in the NEO study

Bordbar

Mutsert

Cevval

et al. 2021

Preprint

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Background: Statins are a potential treatment for venous thromboembolism (VTE) prophylaxis complementary to conventional anticoagulants without associated bleeding complications. The aim of this study was to compare prothrombotic 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 procoagulant factor outcomes.Methods: This is a cross-sectional analysis of participants from the Netherlands Epidemiology of Obesity study who were using any class of lipid-lowering drugs, including any types of statins, niacin, and fibrates. We performed linear regression analyses to determine the activity of fibrinogen, factor (F)VIII, FIX, and FXI in statins versus fibrate/niacin users and adjusted for age, sex, tobacco smoking, body mass index (BMI), hypertension, diabetes, and prevalent cardiovascular disease.Results: Among 1043 participants, the mean age was 58.39± 5.19 years, 61% were men, and mean BMI was 31.3± 4.5 kg/m2. Clinical characteristics were balanced between statin and fibrate/niacin users. Statin users had lower mean FVIII (15.8 IU/dL, 95% confidence interval (CI) -0.003 to 31.6), FIX (11.3 IU/dL, 95% CI -0.4 to 23.2) and FXI (18.3 IU/dL, 95% CI 9.4 to 27.3) levels, and higher mean fibrinogen levels (19.1 mg/dL, 95% CI -10.0 to 48.2) compared to fibrate/niacin users.Conclusion: Current statin use was associated with lower plasma levels of FVIII, FIX, FXI, and higher fibrinogen levels compared to fibrate/niacin use. These 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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Statin use and risk of recurrent venous thrombosis: results from the MEGA follow‐up study

Cited by 14 publications

References 33 publications

Preoperative oncologic therapy and the prolonged risk of venous thromboembolism in resectable pancreatic cancer

Preoperative oncologic therapy and the prolonged risk of venous thromboembolism in resectable pancreatic cancer

Differential effect of statin use on coagulation markers: an active comparative analysis in the NEO study

Differential effect of statin use on coagulation markers: an active comparative analysis in the NEO study

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