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Semin Thromb Hemost 2019; 45(08): 825-833
DOI: 10.1055/s-0039-1687911
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Statin Therapy to Revert Hypercoagulability and Prevent Venous Thromboembolism: A Narrative Review

Fernanda A. Orsi
1   Department of Clinical Pathology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
2   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
,
Suzanne C. Cannegieter
2   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
3   Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
4   Department of Internal Medicine, Section of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
,
Willem M. Lijfering
2   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
3   Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
› Institutsangaben
Funding F.A.O. received financial support from São Paulo Research Foundation (FAPESP grant#2017/09506–5).
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Publikationsdatum:
16. Mai 2019 (online)

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Abstract

Venous thromboembolism (VTE) causes a major disease burden worldwide, so that effective preventive measures are warranted. Although oral anticoagulation is effective in preventing VTE episodes, bleeding complications are a major concern that may lead to treatment avoidance. Statin therapy, which is widely used for prevention of arterial cardiovascular disease, is a promising alternative treatment for VTE prophylaxis, as the drug may affect hemostasis without increasing the risk of bleeding. In the past years, clinical studies have suggested that statins can interfere with blood coagulation and, in turn, reduce the risk of VTE. These effects, however, are still regarded with skepticism, as the underlying mechanisms by which statins may affect hemostasis in humans are not clear and data showing that statin therapy reduces VTE risk mostly came from observational studies, while only one randomized trial was conducted to evaluate this issue. In this review, the authors summarize the currently available evidence regarding the effect of statin therapy on coagulation and on VTE prevention. Recent randomized data showed that statin therapy, in particular rosuvastatin, leads to decreased levels of coagulation factors in patients with prior VTE. This evidence provides a reasonable basis for interventional studies necessary to establish the efficacy of statins on reducing the risk of incident and recurrent VTE.

Keywords

blood coagulation - clinical trials - hydroxymethylglutaryl-CoA reductase inhibitors - prevention - venous thrombosis