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Rosuvastatin reduces risk of venous thromboembolism in healthy adults

Reuters Health • The Doctor's Channel Daily Newscast

ORLANDO (Reuters Health) – New findings, announced here during the annual meeting of the American College of Cardiology, show that rosuvastatin significantly reduces the risk of venous thromboembolism (VTE) in apparently healthy adults.

Results from the JUPITER (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) study have also been published in an Online First issue of The New England Journal of Medicine.

In this substudy of JUPITER, 17,802 initially healthy adults were randomized to rosuvastatin, 20 mg daily, or placebo for a median of 1.9 years, with the primary objective of preventing a first VTE.

Baseline low-density lipoprotein (LDL) cholesterol levels were below 130 mg/dL (3.4 mmol/l) and high-sensitivity C-reactive protein (CRP) levels were 2.0 mg/L or higher.

“Active treatment was associated with a significant reduction in the occurrence of venous thromboembolism,” principal investigator Dr. Paul M. Ridker of Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts, told meeting attendees.

There were 94 cases of symptomatic pulmonary embolism (PE) or DVT, with 34 occurring in the rosuvastatin group and 60 in the placebo group. The rates of VTE were 0.18 per 100 person-years of follow-up with active treatment and 0.32 events per 100 person-years with placebo, for a hazard ratio of 0.57 with rosuvastatin. Cumulative-incidence curves did not diverge until after a year of therapy.

“There was a 43% reduction in VTE with rosuvastatin. The effect was slightly stronger for DVT than PE, but it was of marginal clinical significance,” Dr. Ridker announced.

“The bottom line is that elevated LDL or CRP is associated with risk of VTE,” Dr. Ridker asserted.”

“Once again, we saw virtually no relation between LDL level and CRP level on an individual patient basis. “We need to know both values…and it is best if the LDL level is below 70 mg/dL and CRP has been lowered more than 50%,” Dr. Ridker added.

“Statins probably don’t prevent VTE through lipid reduction. About half the JUPITER population had elevated CRP levels, “he commented. “Statins probably cause a shift in cell signaling that results in mild anticoagulation.”

N Engl J Med 2009;360.

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