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Initiation of statins and risk of venous thromboembolism: Population-based matched cohort study

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Nils Skajaa
  • Szimonetta K Szépligeti
  • Erzsébet Horváth-Puhó
  • Waleed Ghanima, Department of Medicine, Østfold Hospital, Kalnes, Norway; Department of Hematology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • ,
  • John-Bjarne Hansen, K.G. Jebsen Thrombosis Research and Expertise Center, Department of Clinical Medicine, Arctic University of Norway, Tromsø, Norway; Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
  • ,
  • Henrik Toft Sørensen

BACKGROUND: The effects of statins in prevention of venous thromboembolism (VTE) is not well established.

OBJECTIVES: To examine the risks of first-time VTE in a cohort of patients initiating statin treatment and in a matched general population comparison cohort.

METHODS: We conducted a nationwide, population-based, matched cohort study based on data from Danish health registries. The study period was 1 January 2005-31 December 2015. We identified statin initiators (without VTE, myocardial infarction, or ischemic stroke) and sex-, age-, and calendar year-matched (1,3) individuals from the general population (without statin use, VTE, myocardial infarction, or ischemic stroke). We computed cumulative risks and comorbidity-adjusted hazard ratios (HRs) of VTE, myocardial infarction, and ischemic stroke.

RESULTS: Among 601,011 statin initiators and 1,803,033 matched population cohort members during 2005-2015, the cumulative risk after 11 years was 2.8% for VTE (both cohorts), 4.7% vs. 2.9% for myocardial infarction, and 7.1% vs. 5.2 for ischemic stroke. After adjustment, statin use was associated with a slightly decreased risk of VTE (adjusted HR: 0.95 [95% CI: 0.92-0.97]), driven by a reduced risk of unprovoked VTE (adjusted HR: 0.92 [95% CI: 0.89-0.95]). The reduced risks of VTE were more pronounced among patients who had an imaging examination performed. The adjusted HRs were elevated for myocardial infarction and ischemic stroke.

CONCLUSION: Statin initiation was associated with a reduced risk of VTE, with no indication of a healthy-user effect. Based on available evidence, statins have weak thromboprophylactic effects.

OriginalsprogEngelsk
TidsskriftThrombosis Research
Vol/bind184
Sider (fra-til)99-104
Antal sider6
ISSN0049-3848
DOI
StatusUdgivet - 2019

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