Statin Use And The Risk Of Venous Thromboembolism In Women Taking Hormone Therapy

Abstract

Background. Post-menopausal hormone therapy (HT) may elevate the risk of venous thromboembolism (VTE), while statin therapy may lower risk. Purpose. To estimate VTE risk from HT exposure with/without statin therapy in women 50-64 years of age. Methods. A case-control study in a large commercially-insured database matched cases of VTE diagnoses (1:10) to controls without VTE on age +/- 2 yrs. Conditional logistic regression estimated odds ratios (ORs) for recent HT exposure (any estrogen and/or progestogen within 60 days) and current statin therapy (>90 days continuous exposure) controlling for VTE risk factors, comorbidities, and coronary artery disease. Results. In a comparison of cases (n=20,359) and matched controls (n=203,590), 9% (n=19,558) had recent HT exposure and 16% (n=36,238) had current/continuous statin exposure. After adjustment for all covariates, the OR for any recent HT exposure (regardless of statin exposure) was 1.51 (95% CI: 1.43, 1.60) compared to no HT exposure. The OR for current statin therapy (regardless of HT exposure) was 0.88 (95% CI: 0.84, 0.93). For those with HT exposure without statin therapy the OR was 1.53 (95% CI: 1.44, 1.63), for those with HT exposure with statin therapy the OR was 1.25 (95% CI: 1.10, 1.43), and for those exposed to statin therapy without HT exposure the OR was 0.89 (95% CI: 0.85, 0.94), compared those not exposed to either statin or HT. HT with statin therapy had a 18% significantly lower odds ratio than HT without statin therapy (OR=0.82, 95% CI: 0.71, 0.94). High intensity statin therapy showed greater risk reduction. Conclusion. Statin therapy may reduce VTE risk associated with HT.