Statin Treatment Reduces the Incidence of Recurrent Pulmonary Embolism: a Population Based Case-Control Study

Blood(2010)

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Abstract Abstract 808 Background: Recurrence of pulmonary embolism (PE) has a high incidence of 5–10% and is associated with increased mortality. Long-term anticoagulant treatment is however associated with an increased bleeding risk. It is therefore essential to investigate other treatment strategies to reduce the long-term recurrence of PE. Statins seem to reduce a first episode of thrombosis, but whether they also have an effect on recurrent pulmonary embolism (PE) is unknown. Methods: A case-control study was conducted using data from the PHARMO Record Linkage System, a Dutch population-based registry of pharmacy records linked with hospital discharge records. Cases were patients hospitalized with a primary diagnosis of PE between 1998 and 2006. Four controls without a history of PE were matched to each case for age, gender and geographic region. Results: The study population consisted of 4.495 PE cases and 16.802 controls. The median age of the study population was 60 years (range 18–96) and 57% was female. Overall, 9% of both cases and controls used statins (odds ratio (OR) 0.95; 95% confidence interval (CI) 0.84–1.07); only rosuvastatin use reduced PE (OR 0.47; 95% CI 0.24–0.92). During a median follow-up period of 4.1 years (range 2.2–6.6), 396 (11%) patients had a recurrent PE. Statin treatment strongly reduced the incidence of recurrent PE (HR 0.57; 95% CI 0.42–0.79), which persisted after adjustment for vitamin K antagonists, duration of statin use, type of VTE or cardiovascular history. Conclusions: Statin treatment seems to be highly effective in the reduction of recurrent pulmonary embolism. Considering the low rate of side effects, statins may be an interesting option for long-term secondary prevention in patients with PE. Disclosures: No relevant conflicts of interest to declare.
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