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HSR&D 2004 National Meeting Abstracts

1012. Statins Do Not Reduce the Risk of Venous Thromboembolism Among Men
Christopher L Bryson, MD, MS, VA Puget Sound, Northwest HSR&D COE and University of Washington, CJM Doggen, Leiden University Medical Center, DH Au, VA Puget Sound, Northwest HSR&D COE, EJ Boyko, VA Puget Sound, Northwest HSR&D COE and University of Washington, SD Fihn, VA Puget Sound, Northwest HSR&D COE and University of Washington

Objectives: Recently, it has been described that statins may reduce the incidence of venous thromboembolism (VT). We sought to assess whether HMG-CoA reductase inhibitors (statins) are associated with a decreased risk of VT.

Methods: We examined a cohort of male veterans enrolled in the Ambulatory Care Quality Improvement Project, a randomized trial of quality improvement started in 1997 at 7 VA primary care clinics. VT events, including either deep venous thrombosis or pulmonary embolism, were defined based on administrative records requiring an ICD9 discharge diagnosis, a diagnostic test, and either treatment with warfarin or death. Using computerized pharmacy records, patients who received a statin for more than 80% of the month were considered exposed. Cox models with time-dependent covariates were used to evaluate the risk of VT and adjust for potential confounders, including hospitalizations, fractures, cancer, and warfarin use.

Results: There were 35,327 eligible patients in the cohort followed over a median of 3 years, who experienced 156 VT events. Thirty percent of all patients took a statin during follow-up. After adjustment for potential confounders, male statin users did not have fewer VT events than non-users (HR 1.05, 95% CI 0.68 - 1.62). Warfarin use was associated with a 60% reduction in VT (HR 0.36, 95% CI 0.18 0.74).

Conclusions: Statin use was not associated with a decreased risk of VT in male veterans.

Impact: The anti-thrombotic and anti-inflammatory properties previously reported with statins may not be relevant to VT events in the veteran population.