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. 2024 May 18.
doi: 10.1007/s11239-024-03002-0. Online ahead of print.

Statins use and recurrent venous thromboembolism in the direct oral anticoagulant era: insight from the COMMAND VTE Registry-2

Hiroshi Mabuchi  1 , Ryusuke Nishikawa  2 , Yugo Yamashita  3 , Takeshi Morimoto  4 , Ryuki Chatani  5 , Kazuhisa Kaneda  2 , Yuji Nishimoto  6 , Nobutaka Ikeda  7 , Yohei Kobayashi  8 , Satoshi Ikeda  9 , Kitae Kim  10 , Moriaki Inoko  11 , Toru Takase  12 , Shuhei Tsuji  13 , Maki Oi  14 , Takuma Takada  15 , Kazunori Otsui  16 , Jiro Sakamoto  17 , Yoshito Ogihara  18 , Takeshi Inoue  19 , Shunsuke Usami  20 , Po-Min Chen  21 , Kiyonori Togi  22 , Norimichi Koitabashi  23 , Seiichi Hiramori  24 , Kosuke Doi  25 , Yoshiaki Tsuyuki  26 , Koichiro Murata  27 , Kensuke Takabayashi  28 , Hisato Nakai  29 , Daisuke Sueta  30 , Wataru Shioyama  31 , Tomohiro Dohke  32 , Koh Ono  2 , Yoshihisa Nakagawa  31 , Takeshi Kimura  28
Affiliations

Statins use and recurrent venous thromboembolism in the direct oral anticoagulant era: insight from the COMMAND VTE Registry-2

Hiroshi Mabuchi et al. J Thromb Thrombolysis. .

Abstract

Statins were reported to have a potential effect of primary prevention of venous thromboembolism (VTE), although that of secondary prevention remains uncertain. To investigate the association between statins use and recurrent VTE in the current era. The COMMAND VTE Registry-2 is a multicenter registry enrolling 5,197 consecutive VTE patients among 31 centers in Japan between January 2015 and August 2020. We divided the entire cohort into 2 groups according to statins use at the time of discharge; the statins (N = 865) and no statins groups (N = 4332). The statins group was older (72.9 vs. 66.7 years, P < 0.001), and less often had active cancer (22.0% vs. 30.4%, P < 0.001). The cumulative incidence of discontinuation of anticoagulation was significantly lower in the statins group (60.3% vs. 52.6%, Log-rank P < 0.001). The cumulative 5-year incidence of recurrent VTE was significantly lower in the statins group (6.8% vs. 10.1%, Log-rank P = 0.01). Even after adjusting for the confounders, the lower risk of the statins group relative to the no statins group remained significant for recurrent VTE (HR 0.65, 95% CI 0.45-0.91, P = 0.01). The cumulative 5-year incidence of major bleeding was significantly lower in the statins group (12.2% vs. 14.1%, Log-rank P = 0.04), although, after adjusting for the confounders, the risk of the statins group relative to the no statins group turned to be insignificant (HR 0.77, 95% CI 0.59-1.00, P = 0.054). In this large real-world VTE registry, statins use was significantly associated with a lower risk for the recurrent VTE in the current era.

Keywords: Recurrence; Statin; Venous thromboembolism.

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