Statin use and mortality in patients with deep vein thrombosis. Data from the RIETE Registry

Abstract

Background: The association between statin use and mortality in patients with deep vein thrombosis (DVT) has not been rigorously evaluated. Methods: We used the data in the RIETE registry to examine the association between statin use and mortality at 3 months. We used mixed effects survival models accounting for clinical covariates and clustering of patients in enrolling centers. Results: From January 2009 through April 2022, there were 46,440 patients with isolated DVT in RIETE (in the lower-limbs 42,291, in the upper limbs 4149). Of these, 21 % and 18 %, respectively, were using statins. Statin users were older than non-users (72 ± 12 vs. 62 ± 18 years), and more likely had diabetes, hypertension, prior myocardial infarction or ischemic stroke, or were receiving antiplatelets. The 3-month mortality rates were: 6.0 % vs. 5.8 %, respectively. On multilevel multivariable analysis, the adjusted hazard ratio (aHR) for all-cause death in statin users vs. non-users was 0.77 (95%CI: 0.69–0.86). The 3-month risk of death in statin users was significantly lower than in non-users in patients with upper-limb DVT (aHR: 0.81; 95%CI: 0.72–0.91), distal lower-limb DVT (aHR: 0.48; 95%CI: 0.32–0.72), or proximal lower-limb DVT (aHR: 0.69; 95%CI: 0.50–0.95), and in those receiving simvastatin (aHR: 0.73; 95%CI: 0.60–0.90), atorvastatin (aHR: 0.70; 95%CI: 0.59–0.85), or rosuvastatin (aHR: 0.47; 95%CI: 0.27–0.80). Major bleeding, used as a falsification endpoint, did not show an association with use of statins at 3-month follow-up. Conclusions: Statin users with isolated DVT were at significantly lower risk for death at 3 months than non-users.