title: Statin use in patients with nephrotic syndrome is associated with a lower risk of venous thromboembolism.
abstract: BACKGROUND
  Nephrotic syndrome (NS) is a well-known risk factor for venous thromboembolism (VTE), however preventive measures are not routinely taken. In non-renal populations, statins are associated with lower risk of VTE. Hence, we set up this single-center retrospective cohort study to assess whether statin use influenced VTE risk in NS subjects.
  
  
  METHODS
  We analyzed 289 consecutive patients with NS (defined by proteinuria ≥ 3.5 g/day) who were aged >18 years at the study entry and followed for at least 6 months. Use of statins and concomitant medication were determined.
  
  
  RESULTS
  Of patients with NS (59% men; mean age, 42 years), 48% used statins for at least 1 month during NS. Using univariate and time-dependent Cox regression analyses, hazard ratio for VTE in statin users versus non-users was 0.2 (95%CI, 0.1-0.7) and 0.6 (95% CI, 0.2 -2.0), respectively. Adjustments for potential confounders did not change outcomes. Three VTE events occurred in a total of 812 statin-years, corresponding to an annual incidence of 0.37% (95%CI, 0.12-1.15). In contrast, 17 VTE occurred in a total of 2106 patient-years without statin exposure, annual incidence 0.81% (95%CI, 0.50-1.30).
  
  
  CONCLUSIONS
  Although statistically significant, the hazard ratio of 0.2 for VTE risk in statin users versus non-users could have been biased, but the time-dependent hazard ratio of 0.6 was probably not. As the association was in the same direction for both analyses, we conclude that statin use is associated with a lower risk of VTE in patients with NS.
authors.affiliation: Division of Hemostasis and Thrombosis, Department of Hematology, University Medical Center Groningen, The Netherlands. m.resh@onco.umcg.nl
authors.forename: Mohammad
authors.initials: M
authors.lastname: Resh
authors.forename: Bakhtawar K
authors.initials: BK
authors.lastname: Mahmoodi
authors.forename: Gerjan J
authors.initials: GJ
authors.lastname: Navis
authors.forename: Nic J G M
authors.initials: NJ
authors.lastname: Veeger
authors.forename: Willem M
authors.initials: WM
authors.lastname: Lijfering
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood / Q000188:drug therapy*; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors