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Statins during Anticoagulation for Emergency Life-Threatening Venous Thromboembolism: A Review

Authors :
Carmine Siniscalchi
Egidio Imbalzano
Tiziana Meschi
Andrea Ticinesi
Beatrice Prati
Manuela Basaglia
Giuseppe Camporese
Alessandro Perrella
Andreev Viorica
Elisa Eletto
Vincenzo Russo
Paolo Simioni
Source :
Medicina, Vol 60, Iss 8, p 1240 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Venous thromboembolism (VTE) is the leading cause of morbidity and death worldwide, after cancer and cardiovascular diseases. VTE is defined to include pulmonary embolism (PE) and/or deep vein thrombosis (DVT). Approximately 25% of PE patients experience sudden death as an initial symptom of VTE, and between 10% and 30% of patients die within the first month after diagnosis. Currently, the only drugs approved for the treatment of both acute and chronic VTE are vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs). However, their effectiveness is limited due to their associated risk of bleeding. Ideally, therapy should be able to treat VTE and limit the risk of VTE recurrence without increasing the risk of bleeding. Several studies have shown that the use of statins during anticoagulation for VTE reduces the risk of death and VTE recurrence. However, to date, there are conflicting data on the impact of statins during anticoagulation for VTE. A biological protective function of statins during anticoagulation has also been reported. Statins affect D-dimer levels; tissue factor (TF) gene expression; and VIII, VII, and Von Willebrand clotting factors—the major clotting factors they are able to affect. However, the usefulness of statins for the treatment and prevention of VTE is currently under debate, and they should not be substituted for guideline-recommended VTE prophylaxis or anticoagulation treatment. In this review of the literature, we illustrate the advances on this topic, including data on the role of statins in primary VTE prevention and secondary VTE prevention, related biological mechanisms, the risk of bleeding during their use, and their ability to reduce the risk of death.

Details

Language :
English
ISSN :
16489144 and 1010660X
Volume :
60
Issue :
8
Database :
Directory of Open Access Journals
Journal :
Medicina
Publication Type :
Academic Journal
Accession number :
edsdoj.2a83bd6fe5c54e28837abbd393492585
Document Type :
article
Full Text :
https://doi.org/10.3390/medicina60081240