Is lipid lowering therapy an independent risk factor for venous thromboembolism? A population-based case-control study

Thromb Res. 2015 Jun;135(6):1110-6. doi: 10.1016/j.thromres.2015.04.005. Epub 2015 Apr 11.

Abstract

Introduction: The independent effect of lipid lowering therapy (LLT) on venous thromboembolism (VTE) risk is uncertain.

Objective: To test statin and non-statin LLT as potential VTE risk factors.

Methods: Using Rochester Epidemiology Project resources, we identified all Olmsted County, MN residents with objectively diagnosed incident VTE (cases) over the 13-year period, 1988-2000 (n=1340), and one to two matched controls (n=1538). We reviewed their complete medical records for baseline characteristics previously identified as independent VTE risk factors, and for statin and non-statin LLT. Using conditional logistic regression, we tested the overall effect of LLT on VTE risk and also separately explored the role of statin versus that of non-statin LLT, adjusting for other baseline characteristics.

Results: Among cases and controls, 74 and 111 received statin LLT, and 32 and 50 received non-statin LLT, respectively. Univariately, and after individually controlling for other potential VTE risk factors (i.e., BMI, trauma/fracture, leg paresis, hospitalization for surgery or medical illness, nursing home residence, active cancer, central venous catheter, varicose veins, prior superficial vein thrombosis, diabetes, congestive heart failure, angina/myocardial infarction, stroke, peripheral vascular disease, smoking, anticoagulation), LLT was associated with decreased odds of VTE (unadjusted OR=0.73; p=0.03). When considered separately, statin and non-statin LLT were each associated with moderate, non-significant lower odds of VTE. After adjusting for angina/myocardial infarction, each was significantly associated with decreased odds of VTE (OR=0.63, p<0.01 and OR=0.61, p=0.04, respectively).

Conclusions: LLT is associated with decreased VTE risk after adjusting for known risk factors.

Keywords: Epidemiology; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypolipidemic Agents; Pulmonary Embolism; Venous Thrombosis; Venous thromboembolism.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Coronary Disease / prevention & control
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hyperlipidemias / complications
  • Hyperlipidemias / drug therapy*
  • Lipids / blood*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Odds Ratio
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / etiology
  • Risk Factors
  • Venous Thromboembolism / diagnosis*
  • Venous Thromboembolism / etiology*
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / etiology
  • Young Adult

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids