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
