Statin and all-cause mortality in patients receiving anticoagulant therapy for venous thromboembolism. Data from the RIETE registry

Siniscalchi, Carmine; Quintavalla, Roberto; Rocci, Anna; Riera-Mestre, Antoni; Trujillo-Santos, Javier; Maria Surinach, Jose; Jara-Palomares, Luis; Bikdeli, Behnood; Moustafa, Fares; Monreal, Manuel; RIETE Investigators,; Vanassche, T

doi:10.1016/j.ejim.2019.07.028

Statin and all-cause mortality in patients receiving anticoagulant therapy for venous thromboembolism. Data from the RIETE registry

Author:

Siniscalchi, Carmine

Quintavalla, Roberto ; Rocci, Anna ; Riera-Mestre, Antoni ; Trujillo-Santos, Javier ; Maria Surinach, Jose ; Jara-Palomares, Luis ; Bikdeli, Behnood ; Moustafa, Fares ; Monreal, Manuel ; RIETE Investigators, ; Vanassche, T

Keywords:

Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, Statins, Venous thomboembolism, Death all-causes, Fatal bleeding, Fatal pulmonary embolism, ISCHEMIC-STROKE, PULMONARY-EMBOLISM, EXTENDED TREATMENT, PREVENTION, RISK, METAANALYSIS, ASSOCIATION, RECURRENCE, ASPIRIN, Aged, Anticoagulants, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Middle Aged, Pulmonary Embolism, Recurrence, Registries, Risk Factors, Venous Thromboembolism, RIETE Investigators, 1103 Clinical Sciences, 3201 Cardiovascular medicine and haematology, 3202 Clinical sciences

Abstract:

BACKGROUND: The clinical outcomes during the course of anticoagulation in patients with venous thromboembolism (VTE) using statins remain controversial. METHODS: We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to compare the risk for VTE recurrences, major bleeding or death during anticoagulation, according to the use of statins at baseline. We used propensity score-matching (PSM) to adjust for confounding variables. RESULTS: From February 2009 to January 2018, 32,062 VTE patients were included. Of these, 7,085 (22%) were using statins. Statin users were 10 years older (73±11 vs. 63±19 years, respectively) and more likely to have comorbidities or to be using antiplatelets or corticosteroids at baseline than non-users. During the course of anticoagulation (median, 177 days), 694 patients developed VTE recurrences, 848 bled and 3,169 died (fatal pulmonary embolism 176, fatal bleeding 121). Statin users had a similar rate of VTE recurrences (hazard ratio [HR]: 0.98; 95%CI: 0.82-1.17), a higher rate of major bleeding (HR: 1.29; 95%CI: 1.11-1.50) and a similar mortality rate (HR: 1.01; 95%CI: 0.93-1.10) than non-users. On PSM analysis, statin users had a significantly lower risk for death (HR: 0.62; 95%CI: 0.48-0.79) and a similar risk for VTE recurrences (HR: 0.98; 95%CI: 0.61-1.57) or major bleeding (HR: 0.85; 95%CI: 0.59-1.21) than non-users. CONCLUSIONS: During anticoagulation for VTE, patients using statins at baseline had a lower risk to die than non-users.