Statins and primary prevention of venous thromboembolism: a systematic review and meta-analysis

Kunutsor, Setor K; Seidu, Samuel; Khunti, Kamlesh

doi:10.1016/s2352-3026(16)30184-3

Cited by 101 publications

(84 citation statements)

References 45 publications

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“…Because the incidence of suicide in diabetes patients was relatively low, OR and HR were approximately close to RR and were assumed to be the same measure and a common estimate of RR, and this strategy had been used in many published meta-analyses of observational studies (20,21,22,23). Besides, SMR was in line regarded as one form of RR in epidemiological researches and was thus conventionally used as the same measure of RR in the present meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

Wang

Shi

et al. 2017

European Journal of Endocrinology

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Background: Previous studies investigating the risk of suicide in diabetes patients reported controversial findings. We did a systematic review and meta-analysis to comprehensively estimate the risk and incidence rate of suicide in diabetic patients. Methods: PubMed, EMBASE and PsycINFO were searched for eligible studies. Random-effects meta-analysis was used to calculate the relative risk (RR) and the incidence rate of suicide in diabetes patients. We also calculated the proportion of deaths attributable to suicide among diabetes patients. Results: 54 studies were finally included, including 28 studies on the suicide risk associated with diabetes, 47 studies on the incidence rate of suicide and 45 studies on the proportion of deaths attributable to suicide. Meta-analysis showed that diabetes could significantly increase the risk of suicide (RR = 1.56; 95% CI: 1.29-1.89; P < 0.001). Subgroup analysis showed that the RR of suicide associated with type 1 diabetes was 2.25 (95% CI: 1.50-3.38; P < 0.001). The pooled incidence rate of suicide in patients with diabetes was 2.35 per 10 000 person-years (95% CI: 1.51-3.64). The pooled proportions of long-term deaths attributable to suicide in type 1 diabetes patients and type 2 diabetes patients were 7.7% (95% CI: 6.0-9.8) and 1.3% (95% CI: 0.6-2.6), respectively. Conclusion: This meta-analysis suggests that diabetes can significantly increase the risk of suicide. Suicide has an obvious contribution to mortality in diabetic patients, especially among type 1 diabetes patients. Effective strategies to decrease suicide risk and improve mental health outcomes in diabetes patients are needed.

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Section: Discussionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

Wang

Shi

et al. 2017

European Journal of Endocrinology

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“…1,2 Age, active malignancy, infection, pregnancy and use of anticoagulants are well known to have an influence on D-dimer levels. [7][8][9] In line with these antithrombotic effects, statin treatment might lead to a 15% lower risk of primary venous thrombosis as confirmed in a recent meta-analysis of intervention studies. These antithrombotic properties are part of what has been referred to as the cholesterol-independent or "pleiotropic" effects of statins, explaining why the benefits observed with statins appear to exceed what might be expected from changes in cholesterol levels alone.…”

Section: Introductionmentioning

confidence: 79%

“…7,48 Several mechanisms have been described to explain these antithrombotic properties. Statins have been shown to significantly lower the risk of primary VTE and therefore might have a role in the prevention of VTEs.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] Use of medication with an effect on thrombus formation, such as HMG-CoA reductase inhibitors, more commonly known as statins, may influence D-dimer levels as well. 7 In clinical practice, D-dimer levels have a central role in diagnostic algorithms to rule out venous thromboembolism (VTE). [7][8][9] In line with these antithrombotic effects, statin treatment might lead to a 15% lower risk of primary venous thrombosis as confirmed in a recent meta-analysis of intervention studies.…”

Section: Introductionmentioning

confidence: 99%

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A revised systematic review and meta‐analysis on the effect of statins on D‐dimer levels

Schol-Gelok

Morelli

Arends

et al. 2019

Eur J Clin Investigation

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Background D‐dimers are generated during endogenous fibrinolysis of a blood clot and have a central role in diagnostic algorithms to rule out venous thromboembolism. HMG‐CoA reductase inhibitors, more commonly called statins, are known to have effects independent of LDL‐cholesterol lowering, including antithrombotic properties. An effect of statins on D‐dimer levels has been reported in a prior systematic review and meta‐analysis, but methodological shortcomings might have led to an overestimated effect. To re‐evaluate the association between statins and D‐dimer levels, we systematically reviewed all published articles on the influence of statins on D‐dimer levels and conducted a novel meta‐analysis (PROSPERO registration number CRD42017058932). Materials and methods We electronically searched EMBASE, Medline Epub, Cochrane, Web of Science and Google Scholar (100 top relevance) (date of last search: 5 October 2017). We included randomized controlled trials, cohort studies and cross‐sectional studies. Two reviewers independently screened all articles retrieved and extracted data on study and patient characteristics, study quality and D‐dimer levels. Results Study‐level meta‐analysis involving 18,052 study participants showed lower D‐dimer levels in those receiving statin treatment than controls (SMD: −0.165, 95% CI −0.234; −0.096, P = <0.001). Sensitivity analyses and additional analyses on treatment duration (<12 weeks vs ≥12 weeks) and type of statin (lipophilic or hydrophilic) did not modify this overall result. Conclusion This meta‐analysis suggests an association between use of statins and reduction of D‐dimer levels, independent of treatment duration and type of statin used. This effect is small but robust, and should be interpreted with caution.

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“…al. who found VTE incidence significantly lower in group of patients treated with statins (the pooled relative risk 0.75 (95%CI, 0.65-0.87; p<0.0001)) [24]. However, there is the lack of strong evidence to use statins for VTE prevention in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Cancer and atherosclerosis – high risk diseases associated with venous thromboembolic disease

Kostrubiec¹

2017

Blood Heart Circ

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Statins and primary prevention of venous thromboembolism: a systematic review and meta-analysis

Abstract: None.

Cited by 101 publications

References 45 publications

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

A revised systematic review and meta‐analysis on the effect of statins on D‐dimer levels

Cancer and atherosclerosis – high risk diseases associated with venous thromboembolic disease

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