Statins for preventing blood clot formation within veins

Venous thrombosis or thromboembolism (VTE) is a condition in which a blood clot (thrombus) forms in a vein and causes a blockage. The blockage most commonly occurs in the ‘deep veins’ of the lower legs, thighs, or pelvis, and is called deep vein thrombosis (DVT). If part or the entire clot breaks away and is carried through the blood (venous) system it is called an embolism. Should the clot reach the lungs, it is known as a pulmonary embolism (PE) and is life threatening. VTE affects about 3,705,000 people worldwide annually and is one of the most preventable causes of hospital deaths. Statins are well known cholesterol-lowering drugs that are used in heart disease. They have other protective effects including anti-clotting properties and may be effective in the prevention of VTE. Our review, based on one large randomised controlled trial (RCT) involving 17,802 participants, investigated rosuvastatin (a type of statin) for the prevention of VTE. The participants were age 50 years or older for men and 60 years or older for women, with no history of cardiovascular disease, a low density lipoprotein (LDL) cholesterol level of less than 3.4 mmol per litre) and a high-sensitivity C-reactive protein level of 2.0 mg per litre or more. Metabolic syndrome was present in 41.7% of participants. We showed that rosuvastatin could reduce the incidence of VTE, particularly VTE that occurred in the presence of cancer, recent trauma, hospitalisation, or surgery, and DVT. It did not reduce the number of cases of PE or deaths after VTE. The risk of fatal and non-fatal heart attacks combined and fatal and non-fatal strokes combined were reduced. Rosuvastatin was not associated with serious adverse events. More RCTs of statins (including rosuvastatin) are needed to evaluate the efficacy of statins in the prevention of VTE.