(274) A Study of Statins and The Risk of Venous Thromboembolism

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 605

Presenting Author(s)

Lade Ayodele, MPH, MBBS, PhD
– Great Falls, Montana, United States

Co-Author(s)

Susan Jick, DSc
– Director, Boston Collaborative Drug Surveillance Program, Lexington, MA, United States
David McManus
– University of Massachusetts Chan Medical School, United States
Howard J. Cabral, PhD, MPH
– Professor of Biostatistics, Boston University School of Public Health, Boston, MA, United States

Background: A significant proportion of adults receive HMG COA reductase inhibitors, also known as statins for hypercholesterolemia due to the lipid-lowering effects of statins which reduces the risk of arterial embolic events, particularly among patients with other cardiovascular risk factors. However, studies have not consistently demonstrated the potential benefits of statins in preventing venous thromboembolism (VTE). Therefore, we conducted this study to investigate the association between statins and VTE.

Objectives: To evaluate the association between statin use and the risk of incident unprovoked VTE among 40-79-year-old patients with hyperlipidemia who received at least one fibrate or statin prescription.

Methods: In this retrospective cohort study, we evaluated the relationship between statin use and incident unprovoked VTE, against an active comparator, fibrate use. The study population comprised 40-79-year-old patients with hyperlipidemia who received at least one fibrate or statin prescription between January 1995 and December 2018 in the United Kingdom Clinical Practice Research datalink (CPRD). The CPRD is an ongoing primary care database with over 725 general practices in the UK which contains data on a representative sample of more than 11 million UK patients recorded by trained general practitioners (GPs) using standard software and coding systems.
We used Kaplan Meier (KM) analysis and Poisson regression with and without propensity score matching and inverse probability of treatment weights (IPTW) to control for time-varying confounding by cholesterol level.

Results: 0.81% (n=1,353) of the overall cohort (n=166,292) developed incident unprovoked VTE. Patients who received statins had a slightly lower risk of VTE compared to those who received fibrates in analyses using the KM method (Log rank test: p=0.0524). The adjusted incident rate ratio (IRR) (95% CI) for VTE calculated using Poisson regression, controlling for serum cholesterol and other baseline covariates, in patients prescribed statins compared to fibrates was 0.77 (0.45-1.33) in the full cohort. The IRR was 0.74 (0.38-1.45) in the propensity score matched analysis and 0.51 (95% conservative CI: 0.34–0.76) in the IPTW analysis.

Conclusions: While the magnitude of effect varied across the different analytic methods, there is evidence for a protective effect of statin use on the occurrence of VTE.