title: Statins are associated with low risk of venous thromboembolism in patients with cancer: a prospective and observational cohort study.
abstract: BACKGROUND
  Patients with cancer are at risk of venous thromboembolism (VTE). Statin-use has been shown to be associated with low risk of VTE in patients without cancer, but data in cancer patients is scarce. The objective of this study was to evaluate the association of statins with risk of VTE in cancer patients in a prospective observational cohort study.
  
  
  METHODS
  Patients with newly diagnosed cancer or progression of disease after remission were included and prospectively followed for a maximum of 2 years. Study endpoint was occurrence of symptomatic VTE.
  
  
  RESULTS
  Patients (n=1434) were followed over a median observation period of 729 days. VTE occurred in 107 (7.5%) patients. At study inclusion, 170 (11.9%) patients took statins. Simvastatin (n=96) and atorvastatin (n=48) were the most frequently prescribed statins. VTE occurred in 6 (3.5%) patients with statins. Patients with statins had a lower risk of VTE than patients without (subhazard ratio 0.43, 95% confidence interval 0.19 to 0.98; p=0.04). In competing risk analysis, the cumulative probability of VTE in patients with statins was 2.94% after 12 months and 3.54% after 24 months, compared to 7.13% and 8.13% in the group without statins (Gray's test: p=0.04).
  
  
  CONCLUSIONS
  This study provides observational evidence for an association between statin use and low risk of VTE in patients with cancer. The role of statins for prevention of cancer-associated VTE needs to be confirmed in randomized, controlled trials.
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090 Vienna, Austria.
authors.forename: Felix
authors.initials: F
authors.lastname: Lötsch
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090 Vienna, Austria.
authors.forename: Oliver
authors.initials: O
authors.lastname: Königsbrügge
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090 Vienna, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Posch
authors.affiliation: Clincial Division of Oncology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090 Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Zielinski
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090 Vienna, Austria.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pabinger
authors.affiliation: Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090 Vienna, Austria. Electronic address: cihan.ay@meduniwien.ac.at.
authors.forename: Cihan
authors.initials: C
authors.lastname: Ay
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D018570:Risk Assessment; D012307:Risk Factors; D019821:Simvastatin / Q000627:therapeutic use*; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin
keywords: Neoplasms; Simvastatin; Statins; Thrombosis; Venous thromboembolism