ABSTRACT
Venous thromboembolism (VTE) is one of the most frequent and serious vascular diseases.
Although the major risk factors of VTE are well recognized, the pathology often develops
in subjects without any obvious precipitating factor. Recent evidence suggests a link
between arterial and venous thrombosis, particularly in patients with idiopathic venous
thrombosis. Therefore, similar or identical risk factors may play a role in the development
of both diseases. A positive association between classical risk factors of atherosclerosis,
including dyslipidemia, and VTE has been reported. Recent studies demonstrated an
association between hypercholesterolemia and objectively verified VTE. Circulating
lipids have been shown to have both prothrombotic- and endothelium-deteriorating properties.
Studies suggested a greater generation of thrombin, endothelial dysfunction, and higher
platelet activity in hyperlipidemic blood. By impeding these mechanisms, statins may
protect against VTE. Observational, controlled studies and two meta-analyses showed
that statins significantly reduced VTE risk, most likely in a process independent
from cholesterol lowering, through mechanisms related to the pleiotropic effects of
these drugs. Currently, it is unknown whether VTE prevention is a class-effect of
statins, or if statins differ in their antithrombotic efficacy, and it is also unknown
if statin benefit is dose-dependent. However, there are also opposite findings about
the efficacy of statins in prevention of VTE. Therefore, the use of statins for prophylaxis
of VTE cannot be generally recommended at this stage. Further studies are needed to
identify those patients who could eventually benefit maximally from treatment with
statins for prevention of VTE.
KEYWORDS
Venous thrombosis - statins - inflammation - coagulation - dyslipidemia
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Pavel PoredosM.D. Ph.D.
Full Professor of Internal Medicine, Department of Vascular Disease, Ljubljana University
Medical Centre
Zaloska 7, SI-1000 Ljubljana, Slovenia
Email: pavel.poredos@kclj.si
