Abstract 12781: Statin Use and Venous Thromboembolism Recurrence: A Combined Nationwide Cohort and Nested Case-control Study
Background: Statins’ effect on venous thromboembolism (VTE) recurrence remains unclear. We examined this association.
Methods: We conducted a nationwide population-based cohort study and a supplementary nested case-control study. Using a hospital registry, we identified all first-time (index) VTE diagnoses during 2004-2011 (n=41,079). From a prescription database, we ascertained information on statin use prior to index diagnosis (cohort analysis) and recurrence diagnosis (case-control analysis) and categorized it as current use (further divided into new and long-term use), former use, and non-use. For recurrent VTE, myocardial infarction, ischemic stroke, major bleeding, and death, we computed hazard ratios (HRs) using Cox regression and odds ratios (ORs) using conditional logistic regression.
Results: The adjusted HR comparing current users with non-users was 0.86 (95% confidence interval [CI], 0.83-0.92) for recurrent VTE. The reduction in the HR was highest for recurrent deep venous thrombosis (HR, 0.72; 95% CI, 0.58-0.88) and independent of concurrent aspirin or anticoagulant use. The case-control analysis yielded similar effect estimates for current use (OR, 0.80 [95% CI, 0.71-0.90] overall and 0.73 [95% CI, 0.62-0.86] for deep venous thrombosis). It also showed an association with recurrent pulmonary embolism (OR, 0.88; 95% CI, 0.75-1.03), whereas no association was observed for this outcome in the cohort design (HR, 1.01; 95% CI, 0.84-1.21). New statin use also reduced the risk of myocardial infarction, stroke, and death, without increasing the risk of major bleeding.
Conclusions: Statin use was associated with a reduced risk of recurrent VTE, driven by the reduced risk of recurrent deep venous thrombosis
- © 2013 by American Heart Association, Inc.