Abstract
Introduction We previously reported that during the course of anticoagulation for venous thromboembolism (VTE) patients using statins were at a lower risk to die than nonusers. Methods We used the R egistro I nformatizado E nfermedad T rombo E mbólica (RIETE) registry to validate our previous findings in a subsequent cohort of patients and to compare the risk of death according to the use of different types of statins. Results From January 2018 to December 2019, 19,557 patients with VTE were recruited in RIETE. Of them, 4,065 (21%) were using statins (simvastatin, 1,406; atorvastatin, 1,328; rosuvastatin, 246; and others, 1,085). During anticoagulation (192 vs.182 days, for statin and no statin users respectively), 500 patients developed a VTE recurrence, 519 suffered major bleeding, and 1,632 died (fatal pulmonary embolism [PE], 88 and fatal bleeding, 78). On multivariable analysis, statin users were at a lower risk to die (hazard ratio [HR] = 0.68; 95% confidence interval [CI]: 0.59–0.79) than nonusers. When separately analyzing the drugs, on multivariable analysis, patients using simvastatin (HR = 0.64; 95% CI: 0.52–0.80), atorvastatin (HR 0.72; 95% CI: 0.58–0.89), or other statins (HR = 0.67; 95% CI: 0.52–0.87) were at a lower risk to die than nonusers. For those using rosuvastatin, difference was not statistically significant (HR = 0.77; 95% CI: 0.50–1.19), maybe due to the sample size. Conclusion Our data validate previous findings and confirm that VTE patients using statins at baseline are at a lower risk to die than nonusers. No statistically differences were found according to type of statins.
Highlights
We previously reported that during the course of anticoagulation for venous thromboembolism (VTE) patients using statins were at a lower risk to die than nonusers
One study found that patients with acute pulmonary embolism (PE) who were using statins at baseline had half the risk to die than nonusers,10 and a case-control study found that statin users presenting with VTE were at a lower risk for death than nonusers
Median duration of anticoagulant therapy was slightly longer in statin users: 192 versus 182 (IQR: 102–345) days, respectively
Summary
We previously reported that during the course of anticoagulation for venous thromboembolism (VTE) patients using statins were at a lower risk to die than nonusers. One study found that patients with acute pulmonary embolism (PE) who were using statins at baseline had half the risk to die than nonusers, and a case-control study found that statin users presenting with VTE were at a lower risk for death than nonusers.. One study found that patients with acute pulmonary embolism (PE) who were using statins at baseline had half the risk to die than nonusers, and a case-control study found that statin users presenting with VTE were at a lower risk for death than nonusers.11 Both studies were based on population registries of records linked with hospital discharge records where the diagnosis of VTE is based on diagnostic codes, and mortality was a secondary outcome. In a recent Registro Informatizado Enfermedad TromboEmbólica (RIETE) study that included 32,062 patients with a first episode of VTE, we observed that those using statins (22% of the whole cohort) demonstrated a 38% lower mortality compared with nonusers.
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