Benefits from statins in anticoagulated venous thromboembolism patients: recent advances.

IF 4.7 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Carmine Siniscalchi, Manuela Basaglia, Pierpaolo Di Micco, Alberto Parise, Nicoletta Cerundolo, Tiziana Meschi
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引用次数: 0

Abstract

Venous thromboembolism (VTE), encompassing deep vein thrombosis and pulmonary embolism, remains a major cause of morbidity and mortality worldwide. Although oral anticoagulation is the cornerstone of VTE treatment, recurrent events and long‑term complications, such as post‑thrombotic syndrome, persist in a significant proportion of patients. Recent evidence suggests that statins, traditionally used for lipid‑lowering therapy, may exert pleiotropic beneficial effects in patients with VTE, particularly those already receiving anticoagulants. These benefits include anti‑inflammatory, antithrombotic (eg, anticoagulant, antiplatelet, and profibrinolytic actions), endothelial‑stabilizing, and immunomodulatory properties. Clinical and observational studies have highlighted that statin use is associated with reduced risk of recurrent VTE and improved survival, even in the absence of hyperlipidemia. This review synthesizes the current evidence on the role of statins in anticoagulated patients with VTE, exploring mechanistic insights, clinical trial data, and real‑world findings. We also discuss the potential synergistic effects between statins and anticoagulants, as well as safety considerations, particularly in elderly and polymedicated populations. Furthermore, we address the limitations of existing studies and outline future research directions to establish whether statins should be systematically considered in secondary prevention strategies for VTE. In conclusion, statins appear to confer significant adjunctive benefits in anticoagulated VTE patients, with an acceptable safety profile. Integration of statins into VTE management may represent a cost‑effective and widely accessible intervention to enhance patient outcomes, though prospective randomized controlled trials are still needed to confirm causality and determine the optimal use.

他汀类药物对抗凝静脉血栓栓塞患者的益处:最新进展。
静脉血栓栓塞(VTE),包括深静脉血栓形成和肺栓塞,仍然是世界范围内发病率和死亡率的主要原因。尽管口服抗凝是静脉血栓栓塞治疗的基石,但很大一部分患者仍存在复发事件和长期并发症,如血栓形成后综合征。最近的证据表明,他汀类药物,传统上用于降脂治疗,可能对静脉血栓栓塞患者,特别是已经接受抗凝治疗的患者发挥多效有益作用。这些益处包括抗炎、抗血栓形成(如抗凝、抗血小板和纤原蛋白溶解作用)、内皮稳定和免疫调节特性。临床和观察性研究强调,他汀类药物的使用与静脉血栓栓塞复发风险降低和生存率提高相关,即使在没有高脂血症的情况下也是如此。这篇综述综合了他汀类药物在静脉血栓栓塞抗凝患者中的作用的现有证据,探索了机制见解、临床试验数据和现实世界的发现。我们还讨论了他汀类药物和抗凝剂之间的潜在协同效应,以及安全性考虑,特别是在老年人和多种药物人群中。此外,我们解决了现有研究的局限性,并概述了未来的研究方向,以确定他汀类药物是否应该系统地考虑在静脉血栓栓塞的二级预防策略中。总之,他汀类药物在抗凝血栓栓塞患者中具有显著的辅助疗效,具有可接受的安全性。将他汀类药物整合到静脉血栓栓塞治疗中可能是一种具有成本效益且可广泛获得的干预措施,可以提高患者的预后,尽管仍需要前瞻性随机对照试验来确认因果关系并确定最佳使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.50
自引率
0.00%
发文量
176
审稿时长
6-12 weeks
期刊介绍: Polish Archives of Internal Medicine is an international, peer-reviewed periodical issued monthly in English as an official journal of the Polish Society of Internal Medicine. The journal is designed to publish articles related to all aspects of internal medicine, both clinical and basic science, provided they have practical implications. Polish Archives of Internal Medicine appears monthly in both print and online versions.
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