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Differential associations between lipid-lowering drugs, statins and fibrates, and venous thromboembolism: role of drug induced homocysteinemia?
Thromb Res 2008; 122(3):314-9TR

Abstract

BACKGROUND

Previous studies reported that statin use was associated with a decreased risk of venous thromboembolism (VTE), whereas no association was found between fibrate use and VTE. This report aims to test the hypothesis that part of these contrasting associations is related to total homocysteine level (tHcy).

MATERIALS AND METHODS

This report from a case-control study included 677 cases hospitalised with confirmed VTE and no major acquired risk factor of VTE and their 677 controls. Statin and fibrate exposure was defined as a current use of drugs at admission. Fasting serum tHcy was measured in all patients.

RESULTS

The estimated odds ratio for VTE related to statin use was 0.53 (CI 95% 0.37-0.78), whereas it was 1.88 (CI 95% 1.29-2.74) for fibrate use. No difference was found for tHcy levels between patients who were current users of statin compared to non users (17.7 micromol/L+/-7.3 in users vs 18.4 micromol/L+/-8.4 in non users, p=0.50). In contrast, fibrate users had a significant higher mean level of tHcy than non users (23.2 micromol/L+/-8.7 in users vs 18.4 micromol/L+/-8.4 in non users, p<0.0001). Nevertheless, adjustment on tHcy level did not alter significance and strength of the association between fibrates and VTE (1.66, CI 95% 1.07-2.59).

CONCLUSIONS

Statin use was associated with a significant decreased risk of VTE, whereas fibrate use was associated with a significant increased risk of VTE. This last association was independent of tHcy levels.

Authors+Show Affiliations

Brest University, GETBO EA 3878, EPI-PHARM, Brest, F-29609, France. karine.lacut@chu-brest.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18048086

Citation

Lacut, Karine, et al. "Differential Associations Between Lipid-lowering Drugs, Statins and Fibrates, and Venous Thromboembolism: Role of Drug Induced Homocysteinemia?" Thrombosis Research, vol. 122, no. 3, 2008, pp. 314-9.
Lacut K, Le Gal G, Abalain JH, et al. Differential associations between lipid-lowering drugs, statins and fibrates, and venous thromboembolism: role of drug induced homocysteinemia? Thromb Res. 2008;122(3):314-9.
Lacut, K., Le Gal, G., Abalain, J. H., Mottier, D., & Oger, E. (2008). Differential associations between lipid-lowering drugs, statins and fibrates, and venous thromboembolism: role of drug induced homocysteinemia? Thrombosis Research, 122(3), pp. 314-9.
Lacut K, et al. Differential Associations Between Lipid-lowering Drugs, Statins and Fibrates, and Venous Thromboembolism: Role of Drug Induced Homocysteinemia. Thromb Res. 2008;122(3):314-9. PubMed PMID: 18048086.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential associations between lipid-lowering drugs, statins and fibrates, and venous thromboembolism: role of drug induced homocysteinemia? AU - Lacut,Karine, AU - Le Gal,Grégoire, AU - Abalain,Jean-Hervé, AU - Mottier,Dominique, AU - Oger,Emmanuel, Y1 - 2007/11/28/ PY - 2007/08/08/received PY - 2007/10/23/revised PY - 2007/10/23/accepted PY - 2007/12/1/pubmed PY - 2008/10/8/medline PY - 2007/12/1/entrez SP - 314 EP - 9 JF - Thrombosis research JO - Thromb. Res. VL - 122 IS - 3 N2 - BACKGROUND: Previous studies reported that statin use was associated with a decreased risk of venous thromboembolism (VTE), whereas no association was found between fibrate use and VTE. This report aims to test the hypothesis that part of these contrasting associations is related to total homocysteine level (tHcy). MATERIALS AND METHODS: This report from a case-control study included 677 cases hospitalised with confirmed VTE and no major acquired risk factor of VTE and their 677 controls. Statin and fibrate exposure was defined as a current use of drugs at admission. Fasting serum tHcy was measured in all patients. RESULTS: The estimated odds ratio for VTE related to statin use was 0.53 (CI 95% 0.37-0.78), whereas it was 1.88 (CI 95% 1.29-2.74) for fibrate use. No difference was found for tHcy levels between patients who were current users of statin compared to non users (17.7 micromol/L+/-7.3 in users vs 18.4 micromol/L+/-8.4 in non users, p=0.50). In contrast, fibrate users had a significant higher mean level of tHcy than non users (23.2 micromol/L+/-8.7 in users vs 18.4 micromol/L+/-8.4 in non users, p<0.0001). Nevertheless, adjustment on tHcy level did not alter significance and strength of the association between fibrates and VTE (1.66, CI 95% 1.07-2.59). CONCLUSIONS: Statin use was associated with a significant decreased risk of VTE, whereas fibrate use was associated with a significant increased risk of VTE. This last association was independent of tHcy levels. SN - 0049-3848 UR - https://www.unboundmedicine.com/medline/citation/18048086/Differential_associations_between_lipid_lowering_drugs_statins_and_fibrates_and_venous_thromboembolism:_role_of_drug_induced_homocysteinemia L2 - https://linkinghub.elsevier.com/retrieve/pii/S0049-3848(07)00401-X DB - PRIME DP - Unbound Medicine ER -