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Published on: June 15, 2011
Statins, inflammation and deep vein thrombosis: a systematic review
April L Rodriguez1, Brandon M Wojcik, Shirley K Wrobleski
1Department of Surgery, Section of Vascular Surgery, Conrad Jobst Vascular Research Laboratories, School of Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI 48109, USA.
Journal of Thrombosis and Thrombolysis
|January 27, 2012
Summary
Statins may reduce venous thromboembolism (VTE) incidence and recurrence by lowering inflammation. This research suggests statins could be a safe add-on therapy for VTE patients, particularly those with elevated C-reactive protein (CRP).
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Inflammation Research
Background:
- Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), poses significant health risks.
- The 2009 JUPITER trial indicated rosuvastatin reduced DVT in non-hyperlipidemic patients with elevated C-reactive protein (CRP).
- The precise impact of statins on thrombosis remains incompletely understood, necessitating further investigation.
Purpose of the Study:
- To review existing literature on the effects of statins on VTE.
- To explore the potential anti-thrombotic mechanisms of statins, particularly their anti-inflammatory properties.
- To assess the potential of statins as adjunctive therapy for VTE management.
Main Methods:
- A comprehensive literature search was conducted across MEDLINE, EMBASE, and PUBMED databases from 1950 to February 2011.
- Keywords included "statins," "hydroxymethylglutaryl-CoA reductase inhibitors," "VTE," "PE," "DVT," and "anti-coagulation" or "inflammation."
- Exclusion criteria comprised editorials, reviews, case reports, meta-analyses, and duplicate studies.
Main Results:
- Statin therapy has been shown to reduce levels of inflammatory biomarkers such as interleukin-6 (IL-6), CRP, and monocyte chemotactic protein 1 (MCP-1), which are often elevated in VTE.
- Reduced IL-6-induced MCP-1 by statins may mitigate vein wall fibrosis, potentially decreasing the risk of post-thrombotic syndrome (PTS) and recurrent DVT.
- The anti-thrombotic effects of statins are likely mediated through their anti-inflammatory actions, with the greatest VTE reduction observed in normolipidemic patients with elevated CRP.
Conclusions:
- Statin therapy demonstrates potential in decreasing the incidence and recurrence of VTE and may reduce the occurrence of PTS.
- The anti-inflammatory effects of statins are the primary mechanism behind their observed benefits in VTE prevention.
- Statins offer a promising, low-bleeding-risk adjunctive pharmacological therapy for select VTE patients, warranting further clinical investigation.
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