Risk of Venous Thromboembolism with Statins: Evidence Gathered via a Network Meta-analysis
Background: Anticoagulants are the mainstay of treatment for venous thromboembolism (VTE). Studies have shown conflicting results regarding statins ability to reduce the incidence of VTE. Aims: To perform a network meta-analysis to determine which lipid-lowering agent was more efficacious in and ha...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2023-09-01
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| Series: | Balkan Medical Journal |
| Online Access: | https://www.balkanmedicaljournal.org/abstract.php?lang=en&id=2524 |
| _version_ | 1797687166729453568 |
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| author | Oğuzhan Birdal Mehmet Saygı Remziye Doğan Ozan Tezen Ali Karagöz İbrahim Halil Tanboğa |
| author_facet | Oğuzhan Birdal Mehmet Saygı Remziye Doğan Ozan Tezen Ali Karagöz İbrahim Halil Tanboğa |
| author_sort | Oğuzhan Birdal |
| collection | DOAJ |
| description | Background: Anticoagulants are the mainstay of treatment for venous thromboembolism (VTE). Studies have shown conflicting results regarding statins ability to reduce the incidence of VTE.
Aims: To perform a network meta-analysis to determine which lipid-lowering agent was more efficacious in and had more evidence regarding reducing the VTE risk.
Study Design: Network meta-analysis of the randomized controlled trials (RCTs).
Methods: RCTs that assessed the effectiveness and safety of statins or fibrates and compared them to a placebo or another statin were eligible for the study. The outcomes examined in the study were deep vein thrombosis, pulmonary embolism, and/or VTE. We conducted a comprehensive search of the Medline database from 1966 to February 2017, using specific search terms related to VTE and statins. Additionally, we screened, and cross-checked relevant systematic reviews and meta-analyses. We performed a network meta-analysis to compare the different lipid-lowering agents to each other and the placebo and their effectiveness.
Results: Twenty-seven RCTs were included in the network meta-analysis (n = 137,940). Pairwise meta-analysis revealed a statistically significant lower incidence of VTE with statins than with placebos (0.79% vs 0.99%, respectively; risk ratios: 0.87, 0.77-0.98; p = 0.022). Rosuvastatin had the most favorable effect in reducing VTE risk than the other statins, fenofibrate, and placebo. Fenofibrate was ranked the worst drug choice, because it increased risk of VTE when compared with the other statins. Rosuvastatin was the best choice for reducing the VTE risk when compared with the placebo (OR: 0.56, 0.42-0.75), atorvastatin (OR: 0.64, 0.44-0.95), pravastatin (OR: 0.50, 0.34-0.74), simvastatin (OR: 0.60, 0.42-0.86) and fenofibrate (OR: 0.37, 0.25-0.56). Compared with a placebo, rosuvastatin reduced the VTE risk by around 45% and fenofibrate increased the risk by 65%.
Conclusion: Rosuvastatin is significantly reduces the risk of VTE when compared with a placebo, other statin subtypes, and fibrate. Furthermore, fenofibrate increased the VTE risk when compared with a placebo and statins. |
| first_indexed | 2024-03-12T01:15:19Z |
| format | Article |
| id | doaj.art-11c5eb01b20042619e6c61d6057f9ddb |
| institution | Directory Open Access Journal |
| issn | 2146-3131 2146-3123 |
| language | English |
| last_indexed | 2024-03-12T01:15:19Z |
| publishDate | 2023-09-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Balkan Medical Journal |
| spelling | doaj.art-11c5eb01b20042619e6c61d6057f9ddb2023-09-13T12:45:46ZengGalenos Publishing HouseBalkan Medical Journal2146-31312146-31232023-09-0140532433210.4274/balkanmedj.galenos.2023.2023-5-26Risk of Venous Thromboembolism with Statins: Evidence Gathered via a Network Meta-analysisOğuzhan Birdal0https://orcid.org/0000-0002-0667-2516Mehmet Saygı1https://orcid.org/0000-0002-7258-2797Remziye Doğan2https://orcid.org/0000-0003-3563-8779Ozan Tezen3https://orcid.org/0000-0002-2774-8348Ali Karagöz4https://orcid.org/0000-0002-0438-2021İbrahim Halil Tanboğa5https://orcid.org/0000-0003-4546-9227Department of Cardiology, Atatürk University Faculty of Medicine, Erzurum, TurkeyClinic of Cardiology, Hisar Intercontinental Hospital, İstanbul, TurkeyClinic of Cardiology, Hisar Intercontinental Hospital, İstanbul, TurkeyClinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training Hospital, İstanbul, TurkeyClinic of Cardiology, Koşuyolu Heart Hospital, İstanbul, TurkeyDepartment of Cardiology and Biostatistics, Nişantaşı University Faculty of Medicine, İstanbul, TurkeyBackground: Anticoagulants are the mainstay of treatment for venous thromboembolism (VTE). Studies have shown conflicting results regarding statins ability to reduce the incidence of VTE. Aims: To perform a network meta-analysis to determine which lipid-lowering agent was more efficacious in and had more evidence regarding reducing the VTE risk. Study Design: Network meta-analysis of the randomized controlled trials (RCTs). Methods: RCTs that assessed the effectiveness and safety of statins or fibrates and compared them to a placebo or another statin were eligible for the study. The outcomes examined in the study were deep vein thrombosis, pulmonary embolism, and/or VTE. We conducted a comprehensive search of the Medline database from 1966 to February 2017, using specific search terms related to VTE and statins. Additionally, we screened, and cross-checked relevant systematic reviews and meta-analyses. We performed a network meta-analysis to compare the different lipid-lowering agents to each other and the placebo and their effectiveness. Results: Twenty-seven RCTs were included in the network meta-analysis (n = 137,940). Pairwise meta-analysis revealed a statistically significant lower incidence of VTE with statins than with placebos (0.79% vs 0.99%, respectively; risk ratios: 0.87, 0.77-0.98; p = 0.022). Rosuvastatin had the most favorable effect in reducing VTE risk than the other statins, fenofibrate, and placebo. Fenofibrate was ranked the worst drug choice, because it increased risk of VTE when compared with the other statins. Rosuvastatin was the best choice for reducing the VTE risk when compared with the placebo (OR: 0.56, 0.42-0.75), atorvastatin (OR: 0.64, 0.44-0.95), pravastatin (OR: 0.50, 0.34-0.74), simvastatin (OR: 0.60, 0.42-0.86) and fenofibrate (OR: 0.37, 0.25-0.56). Compared with a placebo, rosuvastatin reduced the VTE risk by around 45% and fenofibrate increased the risk by 65%. Conclusion: Rosuvastatin is significantly reduces the risk of VTE when compared with a placebo, other statin subtypes, and fibrate. Furthermore, fenofibrate increased the VTE risk when compared with a placebo and statins.https://www.balkanmedicaljournal.org/abstract.php?lang=en&id=2524 |
| spellingShingle | Oğuzhan Birdal Mehmet Saygı Remziye Doğan Ozan Tezen Ali Karagöz İbrahim Halil Tanboğa Risk of Venous Thromboembolism with Statins: Evidence Gathered via a Network Meta-analysis Balkan Medical Journal |
| title | Risk of Venous Thromboembolism with Statins: Evidence Gathered via a Network Meta-analysis |
| title_full | Risk of Venous Thromboembolism with Statins: Evidence Gathered via a Network Meta-analysis |
| title_fullStr | Risk of Venous Thromboembolism with Statins: Evidence Gathered via a Network Meta-analysis |
| title_full_unstemmed | Risk of Venous Thromboembolism with Statins: Evidence Gathered via a Network Meta-analysis |
| title_short | Risk of Venous Thromboembolism with Statins: Evidence Gathered via a Network Meta-analysis |
| title_sort | risk of venous thromboembolism with statins evidence gathered via a network meta analysis |
| url | https://www.balkanmedicaljournal.org/abstract.php?lang=en&id=2524 |
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