On June 14, 2024, the European Heart Journal published a meta-analysis of 45 randomized controlled trials (RCTs), aimed at studying the association between lipid-lowering therapy in the primary prevention of venous thromboembolism (VTE).
The authors conducted a systematic search for studies in PubMed, CENTRAL, and Web of Science, published up to November 2, 2022. From the available database studies, RCTs were selected in which patients were on therapy with statins, ezetimibe, or proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i).
An additive component network meta-analysis was conducted to compare the risk of VTE in patients on lipid-lowering therapy based on long-term observation.
The analysis included 45 RCTs (n = 254933 patients). There were 2084 cases of VTE registered. Compared with placebo, the combination of iPCSK9 with high-intensity statin therapy was associated with the greatest reduction in VTE risk (risk ratio [RR] 0.59; 95% confidence interval [CI] 0.43–0.80). Meanwhile, patients on statin monotherapy only showed a trend (high-intensity therapy (RR 0.84; 95% CI 0.70–1.02); low-/moderate-intensity (RR 0.89; 95% CI 0.79–1.00)). Ezetimibe monotherapy did not affect the risk of VTE (RR 1.04; 95% CI 0.83–1.30).
There was also an observed increase in the total effect of reducing the risk of VTE with increasing intensity of lipid-lowering therapy. Compared with low/moderate-intensity statin monotherapy, the combination of PCSK9 and high-intensity statin was more associated with a reduction in VTE risk (RR 0.66; 95% CI 0.49–0.89).
Thus, according to the meta-analysis data, it has been established that the prescription of lipid-lowering therapy may have significant potential for the prevention of VTE.
