Rosuvastatin improves coagulation profile of patients with prior thrombosis
Rosuvastatin led to improved coagulation profile, in particular lower levels of factor VIII procoagulant activity (VIII:C), among patients who had venous thrombosis (VT) previously, suggesting that statins could reduce the risk of recurrent VT, according to a study presented at the ISTH 2017 Congress in Berlin, Germany.
The study randomized 247 participants (mean age 58 years, 62 percent women), with prior VT and who recently stopped their anticoagulant therapy, to receive rosuvastatin 20 mg/day for 4 weeks or no intervention. Five coagulation factors ─ factor VIII:C, factor VII:C, factor XI:C, von Willebrand factor (VWF:Ag), and D-dimer were measured through blood test at baseline and at the end of the study. [ISTH 2017, abstract LB03]
Mean factor VIII:C ─ the primary endpoint and for which the study was powered ─ was 7.2 IU/dL lower (95 percent confidence interval [CI], -11.5 to -2.9) than baseline in the rosuvastatin arm, while there was no change from baseline in the control arm (mean difference, -0.1 IU/dL, 95 percent CI, -3.0 to 2.9).
After adjusting for age and sex, the reduction in factor VIII:C from baseline remained greater in rosuvastatin users vs nonusers (adjusted difference, -6.7 IU/dL, 95 percent CI, -12.0 to -1.4).
Among 52 rosuvastatin users with high factor VIII:C at baseline (>150 IU/dL), the elevated levels were normalized in 15 participants at the end of study, equivalent to a 12 percent decrease in the percentage of patients with elevated levels.
In contrast, the proportion of patients with high factor VIII:C levels was the same between baseline and end of study among nonusers.
For all the other coagulation factors tested, the mean coagulant activity from baseline was also lower or trended towards lower levels at the end of study in the rosuvastatin compared with the control arms.
“These results encourage conducting a randomized trial to determine whether statin therapy is a good alternative for long term anticoagulant treatment when it reduces the risk of recurrent VT without inducing bleeding,” according to the researchers.
The findings were in keeping with previous observational studies, which indicate that statins may reduce the risk of recurrent VT. One such study is the MESA* study, which showed that the levels of factor VIII, D-dimer, and C-reactive protein were lower among healthy participants who were on statins compared with those who did not take statins. [J Thromb Haemost 2013;11:1078-1084]