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

Kronenberg, Regula Monika; Beglinger, Shanthi; Stalder, Odile; Méan, Marie; Limacher, Andreas; Beer, Jürg Hans; Aujesky, Drahomir; Rodondi, Nicolas; Feller, Martin (2019). Statin therapy and recurrent venous thromboembolism in the elderly: a prospective cohort study. Scientific Reports, 9(1), p. 14804. Nature Publishing Group 10.1038/s41598-019-51374-8

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Kronenberg, Regula Monika; Beglinger, Shanthi; Stalder, Odile; Méan Pascual, Marie; Limacher, Andreas; Aujesky, Drahomir; Rodondi, Nicolas and Feller, Martin

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2045-2322

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

18 Oct 2019 15:30

Last Modified:

24 Oct 2019 09:46

Publisher DOI:

10.1038/s41598-019-51374-8

PubMed ID:

31616014

BORIS DOI:

10.7892/boris.134049

URI:

https://boris.unibe.ch/id/eprint/134049

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