October 27, 2008 (Philadelphia, Pennsylvania) — Patients hospitalized with solid tumors who are also on statin therapy have a significantly lower risk for venous thromboembolism (VTE) than those not taking the lipid-lowering agents, according to research presented here at CHEST 2008, the American College of Chest Physicians 74th Annual Scientific Assembly.
Results of a retrospective case–control study were presented by principal investigator Danai Khemasuwan, MD, a resident in the Department of Internal Medicine at Albert Einstein Medical Center in Philadelphia, Pennsylvania.
The study involved 740 consecutive patients admitted with a variety of solid tumors, including breast, lung, colon, prostate, stomach, esophagus, pancreas, ovary, kidney, and brain cancer, between October 2004 and September 2007. Mean age was 65 years. The study population was roughly half men and half women, and 76% were African American. Patients treated with anticoagulation therapy before hospitalization were excluded from the study.
Patients were divided into statin users and nonusers. Those taking statins for less than 2 months before hospital admission were assigned to the control group. "This is because C-reactive protein levels stabilize at around 8 weeks, showing peak anti-inflammatory effects," Dr. Khemasuwan commented in an interview with Medscape Pulmonary Medicine after he presented his findings. Overall, 26% (n = 194) of patients in the study were receiving statins.
The incidence of VTE in the study population as a whole was 18% (n = 132); among statin users the incidence was 8% (n = 16), and in the control group it was 21% (n = 116; odds ratio [OR], 0.33; 95% CI, 0.192 – 0.578; P < .001).
When analyzed according to risk factors for VTE, such as smoking, metastatic cancer, current use of chemotherapy, immobilization, and use of aspirin, the results "yielded the same results," Dr. Khemasuwan reported.
"Even including all the confounding factors I could find, the risk reduction was still significant," he said. “And even though aspirin doesn’t help reduce the risk of VTE, as reported earlier this year, statins do help.”
"A lot of doctors would stop giving statins to cancer patients because they think the risks may outweigh the benefits..., but this may be another indication for statins in the future," if the findings are confirmed, he commented. Statins may reduce the risk for VTE in this patient population, he said.
"This makes a lot of sense, especially because of the pleiotrophic effects of statins," David D. Gutterman, MD, FCCP, senior associate dean of research at the Medical College of Wisconsin at Milwaukee, and past chair of the Health and Science Policy Committee of the American College of Chest Physicians, told Medscape Pulmonary Medicine. Dr. Gutterman moderated the panel at which the Albert Einstein Medical Center findings were announced.
"The endothelial effects of statins may be more important than the anti-inflammatory effects. The effects occurring on the venous side of the equation may be as important as those that are occurring on the arterial side," Dr. Gutterman pointed out.
"It would be interesting to do a similar study in a different population at high risk," Dr. Gutterman commented to Dr. Khemasuwan, "and it may be easier to do this while you're still a resident!"
Neither Dr. Khemasuwan nor Dr. Gutterman have disclosed any relevant financial relationships.
CHEST 2008: American College of Chest Physicians 74th Annual Scientific Assembly: Abstract AS2202. Presented October 27, 2008.
Medscape Medical News © 2008 Medscape
Cite this: Martha Kerr. Statins Appear to Prevent VTE in Hospitalized Cancer Patients - Medscape - Oct 27, 2008.