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HMG-CoA reductase inhibitors, other lipid-lowering medication, antiplatelet therapy, and the risk of venous thrombosis.
J Thromb Haemost 2009; 7(4):514-20JT

Abstract

BACKGROUND

Statins [3-hydroxymethyl-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors] and antiplatelet therapy reduce the risk of atherosclerotic disease. Besides a reduction of lipid levels, statins might also have antithrombotic and anti-inflammatory properties, and anti-platelet therapy reduces clot formation. We have studied the risk of venous thrombosis with use of statins, other lipid-lowering medication, and antiplatelet therapy.

MATERIALS AND METHODS

Patients with a first episode of deep vein thrombosis in the leg or pulmonary embolism between March 1999 and September 2004 were included in a large population-based case-control study (MEGA study). Control subjects were partners of patients (53%) or recruited via a random-digit-dialing method (47%). Participants reported different all-medication use in a questionnaire.

RESULTS

Of 4538 patients, 154 used statins (3.3%), as did 354 of 5914 control subjects (5.7%). The use of statins [odds ratio (OR) 0.45; 95% confidence interval (CI) 0.36-0.56] but not other lipid-lowering medications (OR 1.22; 95% CI 0.62-2.43), was associated with a reduced venous thrombosis risk as compared with individuals who did not use any lipid-lowering medication, after adjustment for age, sex, body mass index, atherosclerotic disease, antiplatelet therapy and use of vitamin K antagonists. Different types and various durations of statin therapy were all associated with a decreased venous thrombosis risk. Antiplatelet therapy also reduced venous thrombosis risk (OR 0.56; 95% CI 0.42-0.74). However, sensitivity analyses suggested that this effect is most likely explained by a so-called 'healthy user effect'. Simultaneous use of medication most strongly reduced venous thrombosis risk.

CONCLUSION

These results suggest that the use of various types of statins is associated with a reduced risk of venous thrombosis, whereas antiplatelet therapy and other lipid-lowering medications are not.

Authors+Show Affiliations

Department of Clinical Epidemiology, Leiden University Medical Centre, the Netherlands.No affiliation info availableNo 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

19036068

Citation

Ramcharan, A S., et al. "HMG-CoA Reductase Inhibitors, Other Lipid-lowering Medication, Antiplatelet Therapy, and the Risk of Venous Thrombosis." Journal of Thrombosis and Haemostasis : JTH, vol. 7, no. 4, 2009, pp. 514-20.
Ramcharan AS, Van Stralen KJ, Snoep JD, et al. HMG-CoA reductase inhibitors, other lipid-lowering medication, antiplatelet therapy, and the risk of venous thrombosis. J Thromb Haemost. 2009;7(4):514-20.
Ramcharan, A. S., Van Stralen, K. J., Snoep, J. D., Mantel-Teeuwisse, A. K., Rosendaal, F. R., & Doggen, C. J. (2009). HMG-CoA reductase inhibitors, other lipid-lowering medication, antiplatelet therapy, and the risk of venous thrombosis. Journal of Thrombosis and Haemostasis : JTH, 7(4), pp. 514-20. doi:10.1111/j.1538-7836.2008.03235.x.
Ramcharan AS, et al. HMG-CoA Reductase Inhibitors, Other Lipid-lowering Medication, Antiplatelet Therapy, and the Risk of Venous Thrombosis. J Thromb Haemost. 2009;7(4):514-20. PubMed PMID: 19036068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HMG-CoA reductase inhibitors, other lipid-lowering medication, antiplatelet therapy, and the risk of venous thrombosis. AU - Ramcharan,A S, AU - Van Stralen,K J, AU - Snoep,J D, AU - Mantel-Teeuwisse,A K, AU - Rosendaal,F R, AU - Doggen,C J M, Y1 - 2008/11/24/ PY - 2008/11/28/pubmed PY - 2009/8/18/medline PY - 2008/11/28/entrez SP - 514 EP - 20 JF - Journal of thrombosis and haemostasis : JTH JO - J. Thromb. Haemost. VL - 7 IS - 4 N2 - BACKGROUND: Statins [3-hydroxymethyl-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors] and antiplatelet therapy reduce the risk of atherosclerotic disease. Besides a reduction of lipid levels, statins might also have antithrombotic and anti-inflammatory properties, and anti-platelet therapy reduces clot formation. We have studied the risk of venous thrombosis with use of statins, other lipid-lowering medication, and antiplatelet therapy. MATERIALS AND METHODS: Patients with a first episode of deep vein thrombosis in the leg or pulmonary embolism between March 1999 and September 2004 were included in a large population-based case-control study (MEGA study). Control subjects were partners of patients (53%) or recruited via a random-digit-dialing method (47%). Participants reported different all-medication use in a questionnaire. RESULTS: Of 4538 patients, 154 used statins (3.3%), as did 354 of 5914 control subjects (5.7%). The use of statins [odds ratio (OR) 0.45; 95% confidence interval (CI) 0.36-0.56] but not other lipid-lowering medications (OR 1.22; 95% CI 0.62-2.43), was associated with a reduced venous thrombosis risk as compared with individuals who did not use any lipid-lowering medication, after adjustment for age, sex, body mass index, atherosclerotic disease, antiplatelet therapy and use of vitamin K antagonists. Different types and various durations of statin therapy were all associated with a decreased venous thrombosis risk. Antiplatelet therapy also reduced venous thrombosis risk (OR 0.56; 95% CI 0.42-0.74). However, sensitivity analyses suggested that this effect is most likely explained by a so-called 'healthy user effect'. Simultaneous use of medication most strongly reduced venous thrombosis risk. CONCLUSION: These results suggest that the use of various types of statins is associated with a reduced risk of venous thrombosis, whereas antiplatelet therapy and other lipid-lowering medications are not. SN - 1538-7836 UR - https://www.unboundmedicine.com/medline/citation/19036068/HMG_CoA_reductase_inhibitors_other_lipid_lowering_medication_antiplatelet_therapy_and_the_risk_of_venous_thrombosis_ L2 - https://doi.org/10.1111/j.1538-7836.2008.03235.x DB - PRIME DP - Unbound Medicine ER -