title: Is lipid lowering therapy an independent risk factor for venous thromboembolism? A population-based case-control study.
abstract: BACKGROUND
  The independent effect of lipid lowering therapy (LLT) on venous thromboembolism (VTE) risk is uncertain.
  
  
  OBJECTIVE
  To test statin and non-statin LLT as potential VTE risk factors.
  
  
  METHODS
  Using Rochester Epidemiology Project resources, we identified all Olmsted County, MN residents with objectively diagnosed incident VTE (cases) over the 13-year period, 1988-2000 (n=1340), and one to two matched controls (n=1538). We reviewed their complete medical records for baseline characteristics previously identified as independent VTE risk factors, and for statin and non-statin LLT. Using conditional logistic regression, we tested the overall effect of LLT on VTE risk and also separately explored the role of statin versus that of non-statin LLT, adjusting for other baseline characteristics.
  
  
  RESULTS
  Among cases and controls, 74 and 111 received statin LLT, and 32 and 50 received non-statin LLT, respectively. Univariately, and after individually controlling for other potential VTE risk factors (i.e., BMI, trauma/fracture, leg paresis, hospitalization for surgery or medical illness, nursing home residence, active cancer, central venous catheter, varicose veins, prior superficial vein thrombosis, diabetes, congestive heart failure, angina/myocardial infarction, stroke, peripheral vascular disease, smoking, anticoagulation), LLT was associated with decreased odds of VTE (unadjusted OR=0.73; p=0.03). When considered separately, statin and non-statin LLT were each associated with moderate, non-significant lower odds of VTE. After adjusting for angina/myocardial infarction, each was significantly associated with decreased odds of VTE (OR=0.63, p<0.01 and OR=0.61, p=0.04, respectively).
  
  
  CONCLUSIONS
  LLT is associated with decreased VTE risk after adjusting for known risk factors.
authors.affiliation: Division of Hematology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, United States. Electronic address: ashrani.aneel@mayo.edu.
authors.forename: Aneel A
authors.initials: AA
authors.lastname: Ashrani
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, United States.
authors.forename: Michel K
authors.initials: MK
authors.lastname: Barsoum
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, United States.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Crusan
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, United States.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Petterson
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, United States.
authors.forename: Kent R
authors.initials: KR
authors.lastname: Bailey
authors.affiliation: Division of Hematology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, United States; Division of Cardiovascular Diseases, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, United States; Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, United States.
authors.forename: John A
authors.initials: JA
authors.lastname: Heit
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003327:Coronary Disease / Q000517:prevention & control; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000209:etiology*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology; D055815:Young Adult
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids
keywords: Epidemiology; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypolipidemic Agents; Pulmonary Embolism; Venous Thrombosis; Venous thromboembolism