Concomitant lipid-lowering and anticoagulation therapy for recurrent venous thromboembolism prevention: A Bayesian meta-analysis.

IF 13.3 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Med Pub Date : 2026-09-11 Epub Date: 2026-08-17 DOI:10.1016/j.medj.2026.101262

Harsini Raaja Sulochana, Yufan Yang, Laura Bindila, Ioannis T Farmakis, Stavros V Konstantinides, Luca Valerio, Philipp S Wild, Vincent Ten Cate

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引用次数: 0

Abstract

Background: It is unclear whether combined anticoagulation (AC) plus lipid-lowering therapies (LLTs) enhance AC efficacy for venous thromboprophylaxis while maintaining an acceptable safety profile.

Methods: A systematic literature search was conducted in PubMed, Cochrane CENTRAL library, and Web of Science, including randomized controlled trials (RCTs) and observational studies published until May 2026. The associations of LLT+AC vs. AC monotherapy with efficacy outcomes (i.e., recurrent venous thromboembolism [rVTE] and post-thrombotic syndrome [PTS] risk), safety outcomes (i.e., major bleeding), and other outcomes were analyzed. A Bayesian random-effects meta-analysis was used to aggregate study estimates (95% credible interval [CrI]) and calculate the posterior probability of benefit (relative risk [RR] < 1).

Findings: The search yielded 28 (17 observational studies and 11 RCTs) studies eligible for meta-analysis. The pooled effect size of LLT+AC vs. AC alone for rVTE was RR = 0.73 [95% CrI: 0.58; 1.05, P(RR < 1) = 0.97]. In addition, there was a 17% lower risk observed for PTS [RR = 0.83, 95% CrI: 0.40; 1.59, P(RR < 1) = 0.74]. Major bleeding risk was 15% lower [RR = 0.85, 95% CrI: 0.76; 0.96, P(RR < 1) = 0.99]. Combined LLT+AC reduced D-dimer [log SMD = -0.15; 95% CrI: -0.43; 0.13, P(SMD < 0) = 0.88] and C-reactive protein levels [log SMD = -0.86; 95% CrI: -1.48; -0.08; P(SMD < 0) = 0.98] relative to AC monotherapy.

Conclusions: The available evidence suggests potential benefit of LLT+AC combination therapy over AC monotherapy, with respect to both safety and efficacy, though further evidence from RCTs is necessary to generate conclusive evidence.

Funding: DIASyM research core (BMBF 031L0219).

查看原文本刊更多论文

伴随降脂和抗凝治疗预防静脉血栓栓塞复发：贝叶斯荟萃分析。

背景：目前尚不清楚抗凝治疗（AC）加降脂治疗（LLTs）是否能在保持可接受的安全性的同时增强抗凝治疗在静脉血栓预防中的疗效。方法：系统检索PubMed、Cochrane CENTRAL library和Web of Science的文献，包括截至2026年5月发表的随机对照试验（rct）和观察性研究。分析了LLT+AC与AC单药治疗与疗效结局（即复发性静脉血栓栓塞[rVTE]和血栓形成后综合征[PTS]风险）、安全性结局（即大出血）和其他结局的关系。贝叶斯随机效应荟萃分析用于汇总研究估计（95%可信区间[CrI]）并计算获益的后验概率（相对风险[RR] < 1）。结果：本研究共获得28项（17项观察性研究和11项随机对照试验）符合meta分析的研究。ltt +AC与单独AC治疗rVTE的合并效应值RR = 0.73 [95% CrI: 0.58；1.05, p (rr < 1) = 0.97]。此外，PTS发生风险降低17% [RR = 0.83, 95% CrI: 0.40；1.59, p (rr < 1) = 0.74]。大出血风险降低15% [RR = 0.85, 95% CrI: 0.76；0.96, p (rr < 1) = 0.99]。联合LLT+AC还原d -二聚体[log SMD = -0.15；95% CrI: -0.43；0.13， P(SMD < 0) = 0.88]和c反应蛋白水平[log SMD = -0.86；95% CrI: -1.48；-0.08;P(SMD < 0) = 0.98]。结论：现有证据表明，在安全性和有效性方面，LLT+AC联合治疗比AC单药治疗有潜在的益处，尽管需要进一步的随机对照试验证据来产生结论性证据。资助：DIASyM研究核心（BMBF 031L0219）。

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

Med MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

17.70

自引率

0.60%

发文量

102

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