title: Statins for the prevention of venous thromboembolism? a narrative review.
abstract: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a substantial public health problem. The majority of VTE events are associated with transient periods of heightened risk, such as prolonged hospitalization, undergoing major surgery, experiencing trauma or lower extremity immobility, use of oral contraceptives, or having active cancer. Although pharmacologic thromboprophylaxis agents (eg, unfractionated heparin, low-molecular-weight heparins, warfarin, and novel oral anticoagulants) are effective, they remain underused, with concerns about increased bleeding risk often cited as a reason. The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (ie, statins), although used primarily for lipid lowering and arterial thrombosis risk reduction, have pleiotrophic effects that affect coagulation and inflammation, and do not increase bleeding risk. There is emerging evidence to suggest that through these pleiotrophic effects, statins may be effective in reducing the incidence of VTE. This article summarizes the literature with regard to statins' effect on VTE and suggests that additional investigations are needed to assess a potential adjunctive role for primary VTE thromboprophylaxis.
authors.affiliation: Visiting Instructor, Department of General Internal Medicine, University of Utah Hospital, Salt Lake City, UT. amikar.sehdev@hsc.utah.edu.
authors.forename: Amikar
authors.initials: A
authors.lastname: Sehdev
authors.forename: Nathan
authors.initials: N
authors.lastname: Wanner
authors.forename: Robert C
authors.initials: RC
authors.lastname: Pendleton
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D011655:Pulmonary Embolism / Q000517:prevention & control; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors