Albert Einstein Medical Center, Philadelphia, PA19141, USA.
Am J Med. 2010 Jan;123(1):60-5. doi: 10.1016/j.amjmed.2009.05.025.
Recent data suggest a reduction in the occurrence of venous thromboembolism in select groups of patients who use statins. The objective of this study is to evaluate the impact of statin use on the occurrence of venous thromboembolism in patients with solid organ tumor.
We conducted a retrospective, case-control study reviewing 740 consecutive patients with a diagnosis of solid organ tumor who were admitted to the Albert Einstein Medical Center, Philadelphia, Penn, between October 2004 and September 2007. Patients treated with anticoagulation therapy before their first admission were excluded. The occurrence of venous thromboembolism, risk factors for venous thromboembolism, and statin use were recorded. Patients who never used statins or had used them for less than 2 months were relegated to the control group.
The mean age of the study population was 65 years, and 52% of the patients were women and 76% were African American. The occurrence of venous thromboembolism was 18% (N=132), and 26% (N=194) were receiving statins. Among patients receiving statins, 8% (N=16) developed a venous thromboembolism compared with 21% (N=116) in the control group (odds ratio 0.33; 95% confidence interval, 0.19-0.57). A logistic regression analysis including risk factors for venous thromboembolism (metastatic disease, use of chemotherapy, immobilization, smoking, and aspirin use) along with statin use yielded the same results.
This study suggests that the use of statins is associated with a significant reduction in the occurrence of venous thromboembolism. This pleiotropic effect warrants further investigation.
最近的数据表明,在使用他汀类药物的特定患者群体中,静脉血栓栓塞的发生有所减少。本研究旨在评估他汀类药物的使用对实体瘤患者静脉血栓栓塞发生的影响。
我们进行了一项回顾性病例对照研究,共纳入 2004 年 10 月至 2007 年 9 月期间在宾夕法尼亚州费城爱因斯坦医疗中心就诊的 740 例连续确诊为实体瘤的患者。排除首次入院前接受抗凝治疗的患者。记录静脉血栓栓塞的发生、静脉血栓栓塞的危险因素和他汀类药物的使用情况。从未使用过他汀类药物或使用时间不足 2 个月的患者被归入对照组。
研究人群的平均年龄为 65 岁,52%为女性,76%为非裔美国人。静脉血栓栓塞的发生率为 18%(N=132),26%(N=194)正在服用他汀类药物。在服用他汀类药物的患者中,有 8%(N=16)发生静脉血栓栓塞,而对照组中有 21%(N=116)(比值比 0.33;95%置信区间,0.19-0.57)。在包括静脉血栓栓塞危险因素(转移性疾病、化疗、固定、吸烟和阿司匹林使用)和他汀类药物使用的逻辑回归分析中也得到了相同的结果。
本研究表明,他汀类药物的使用与静脉血栓栓塞发生率的显著降低相关。这种多效性作用值得进一步研究。