title: Statins for primary prevention of venous thromboembolism.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is common in clinical practice. The efficacy of statins in the primary prevention of VTE remains unproven.
  
  
  OBJECTIVE
  To assess the efficacy of statins in the primary prevention of VTE.
  
  
  METHODS
  The Cochrane Peripheral Vascular Diseases (PVD) Group searched their Specialised Register (last searched April 2011) and CENTRAL (2011, Issue 2). The authors searched MEDLINE (January 1966 to March 2011); EMBASE (1974 to March 2011); ISI Web of Knowledge (2001 to March 2011); the Chinese Biomedical Literature Database (1978 to March 2011) and other resources (including clinical trials registers, reference lists and presentations at various conferences.
  
  
  METHODS
  Randomised controlled trials (RCTs) that assessed statins were considered. The outcomes we evaluated were the rates of VTE, cardiovascular and cerebrovascular events, death and adverse events. Two authors independently selected RCTs against inclusion criteria. Disagreements were resolved by discussion with a third author.
  
  
  METHODS
  Data extraction was independently carried out by two authors. Disagreements were resolved by discussion with a third author. Two authors independently assessed the risk of bias according to a standard quality checklist provided by the PVD Group.
  
  
  RESULTS
  We included one RCT (17 citations) with 17,802 participants that assessed rosuvastatin for preventing VTE. Our analysis showed that rosuvastatin reduced the incidence of VTE (odds ratio (OR) 0.57, 95% confidence interval (CI) 0.37 to 0.86) and deep vein thrombosis (DVT) (OR 0.45, 95% CI 0.25 to 0.79), the risk of any (fatal and non-fatal) myocardial infarction (MI) (OR 0.45, 95% CI 0.30 to 0.69), any (fatal and non-fatal) stroke (OR 0.51, 95% CI 0.34 to 0.78), but did not reduce the incidence of pulmonary embolism (PE) (OR 0.77, 95% CI 0.41 to 1.46) and death after VTE (OR 0.50, 95% CI 0.20 to 1.24). Rosuvastatin did not reduce the incidence of any serious adverse event (OR 0.95, 95% CI 0.90 to 1.06).
  
  
  CONCLUSIONS
  Available evidence showed that rosuvastatin was associated with a reduced incidence of VTE, but the evidence was limited to a single RCT. Randomised controlled trials of statins (including rosuvastatin) are needed to evaluate the efficacy of statins in the prevention of VTE.
authors.affiliation: Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 199, Donggang West Road, Lanzhou City, Gansu, China, 730000.
authors.forename: Lun
authors.initials: L
authors.lastname: Li
authors.forename: Tiantian
authors.initials: T
authors.lastname: Sun
authors.forename: Peizhen
authors.initials: P
authors.lastname: Zhang
authors.forename: Jinhui
authors.initials: J
authors.lastname: Tian
authors.forename: Kehu
authors.initials: K
authors.lastname: Yang
mesh_terms: D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use*; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium