Statin use and mortality in patients with deep vein thrombosis. Data from the RIETE Registry

Abstract

BackgroundThe association between statin use and mortality in patients with deep vein thrombosis (DVT) has not been rigorously evaluated. MethodsWe used the data in the RIETE registry to examine the association between statin use and mortality at 3 months. We used mixed effects survival models accounting for clinical covariates and clustering of patients in enrolling centers. ResultsFrom January 2009 through April 2022, there were 46,440 patients with isolated DVT in RIETE (in the lower-limbs 42,291, in the upper limbs 4149). Of these, 21 % and 18 %, respectively, were using statins. Statin users were older than non-users (72 ± 12 vs. 62 ± 18 years), and more likely had diabetes, hypertension, prior myocardial infarction or ischemic stroke, or were receiving antiplatelets. The 3-month mortality rates were: 6.0 % vs. 5.8 %, respectively. On multilevel multivariable analysis, the adjusted hazard ratio (aHR) for all-cause death in statin users vs. non-users was 0.77 (95%CI: 0.69–0.86). The 3-month risk of death in statin users was significantly lower than in non-users in patients with upper-limb DVT (aHR: 0.81; 95%CI: 0.72–0.91), distal lower-limb DVT (aHR: 0.48; 95%CI: 0.32–0.72), or proximal lower-limb DVT (aHR: 0.69; 95%CI: 0.50–0.95), and in those receiving simvastatin (aHR: 0.73; 95%CI: 0.60–0.90), atorvastatin (aHR: 0.70; 95%CI: 0.59–0.85), or rosuvastatin (aHR: 0.47; 95%CI: 0.27–0.80). Major bleeding, used as a falsification endpoint, did not show an association with use of statins at 3-month follow-up. ConclusionsStatin users with isolated DVT were at significantly lower risk for death at 3 months than non-users.