A pilot randomized trial of atorvastatin as adjunct therapy in patients with acute venous thromboembolism
| Autor: | Bryce A. Kerlin, Ken M. Riedl, Abigail Bartosic, Lai Wei, Ella Lin, Tzu-Fei Wang, Amanda P. Waller |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Deep vein Atorvastatin Pilot Projects 030204 cardiovascular system & hematology law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans cardiovascular diseases Aged Rivaroxaban business.industry Warfarin Venous Thromboembolism Hematology General Medicine Middle Aged medicine.disease Thrombosis Pulmonary embolism medicine.anatomical_structure Acute Disease Female lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors business 030215 immunology medicine.drug Post-thrombotic syndrome |
| Zdroj: | Blood Coagulation & Fibrinolysis. 32:16-22 |
| ISSN: | 1473-5733 0957-5235 |
| Popis: | Venous thromboembolism (VTE) is the third most common cardiovascular disease and optimizing treatment is essential. In this single-center pilot study, we sought to investigate the effects of statins in addition to anticoagulation in patients with acute VTE. We enrolled patients over 18 with an acute proximal lower extremity deep vein thrombosis with or without pulmonary embolism. Patients were randomized to anticoagulation alone (with either warfarin or rivaroxaban) or anticoagulation and atorvastatin 40 mg daily and followed for 9 months. The primary objective was to determine if adjunct atorvastatin reduced thrombin generation, measured by endogenous thrombin potential and/or peak thrombin concentration. Secondary endpoints included recurrent VTE, arterial thrombosis, bleeding events, lipidomic profiles, and symptoms of post thrombotic syndrome. A total of 21 patients were enrolled (11 anticoagulation only and 10 anticoagulation and atorvastatin) over 3.5 years. Endogenous thrombin potential or peak thrombin was not significantly recued with the addition of atorvastatin. Atorvastatin did significantly reduce the mean LDLs at 3 months, without reduction of either d-dimer or high-sensitivity-C reactive protein. Given the low recruitment rate, continuation of the study was deemed futile and the study was terminated early. Barriers to enrollment and completion of study included the many ineligible patients by exclusion criteria (e.g., preexisting statin use, active malignancy, etc.) and high rate of lost follow-up. The pilot study was terminated early but could inform obstacles for future studies investigating the effects of statins in the management of patients with VTE. |
| Databáze: | OpenAIRE |
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