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

Author(s)

Orsi, Fernanda A. ^{[1, 2]} ; Cannegieter, Suzanne C. ^{[3, 2, 4]} ; Lijfering, Willem M. ^{[3, 2]}

Affiliation

^[1] Univ Campinas Unicamp, Sch Med Sci, Dept Clin Pathol, Campinas, SP - Brazil

^[2] Leiden Univ, Med Ctr, Dept Clin Epidemiol, Leiden - Netherlands

^[3] Leiden Univ, Med Ctr, Einthoven Lab Expt Vasc Med, Leiden - Netherlands

^[4] Leiden Univ, Med Ctr, Dept Internal Med, Sect Thrombosis & Hemostasis, Leiden - Netherlands

• Document type: Journal article
• Source: SEMINARS IN THROMBOSIS AND HEMOSTASIS; v. 45, n. 8, p. 825-833, NOV 2019.
• Web of Science Citations: 3

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. (AU)

• FAPESP's process: 17/09506-5 - Identification of novel targets for therapy with PCSK9: From LDL lowering to decreased inflammation and coagulation
• Grantee: Fernanda Loureiro de Andrade Orsi
• Support Opportunities: Scholarships abroad - Research