Statins as a preventative therapy for venous thromboembolism

Abstract

The anti-inflammatory effects of statins have likely not been used to their fullest extent, particularly in reducing venous thromboembolic events. Current therapy for thrombotic events hinges on anticoagulation via heparin, warfarin or new oral anticoagulants. Interventional procedures with thrombectomy may also play a critical role. Unfortunately, thrombotic events can occur and recur despite meticulous anticoagulation therapy. Venous thromboembolism (VTE) includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), two complicated and prevalent diseases that can cause chronic disease states such as post-thrombotic syndrome (PTS). In 2009 the JUPITER trial demonstrated that rosuvastatin may be effective when dealing with vascular inflammation by providing an anti-inflammatory effect. Multiple subsequent studies have looked at this association with some promising findings. The mechanism of action for statins is not entirely understood but there has been a variety of proposals and subsequent testing of inflammatory biomarkers. Additional prospective trials are needed to confirm the possible benefit of VTE reduction through an anti-inflammatory effect, but if this can be shown then statins may become a safe adjunctive therapy for VTE prevention.

Acute Pulmonary Embolism and COVID-19

“…We found that patients with COVID-19 receiving statin therapy prior to admission are less likely to develop a PE. Statins have been previously described to be associated with decreased rates of venous thromboembolism, as well as decreased risk of recurrent PE ( 8 , 9 ).…”

Association Between Statin Use and Exacerbation of Chronic Obstructive Pulmonary Disease Among Patients Receiving Corticosteroids

“…Presently, statins have been proven to provide multiple effects, not just hypolipidemic effects. Statins can be used for venous thromboembolism, 22,23 cancers, 24 stroke, [25][26][27]31 and even as an antiarrhythmic drug. [28][29][30] However, statins have already been proven to reduce stroke risk and atherosclerosis mainly by reducing low-density lipoprotein cholesterol, which is exactly the effect of hypolipidemic agents and not by reducing inflammation.…”

Fibrin Clot Formation under Oxidative Stress Conditions

“…The concentration of fibrinogen and alterations in fibrin clot properties could also be mediated by statins, which are used in the management of hyperlipidemia. Statins are associated with the modulation of PAI-1 and tPA activity, influence fibrinogen concentration, and have an impact on fibrinolysis [29][30][31]. Statins could increase the permeability of clots and thus enhance fibrinolysis [30].…”