JupiterThe JUPITER (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) trial evaluated the effects of rosuvastatin use on major cardiovascular events. A recent sub-analysis of the data that was published in the New England Journal of Medicine evaluated for the incidence of venous thromboembolism while on rosuvastatin, compared to placebo.

The study population included 17,802 healthy men and women with low-density lipoprotein (LDL) cholesterol levels <130 mg/dL and C-reactive protein (CRP) > 2.0 mg/L. The study participants either received rosuvastatin 20 mg daily or placebo. During the follow-up period (median 1.9 years, maximum 5.0 years), the rates of venous thromboembolism for the rosuvastatin and placebo groups were 0.18 and 0.32 per 100 person-years, respectively (p = 0.007). There was also a significant difference among the groups when evaluating for provoked venous thromboembolism (i.e., cancer, trauma, hospitalization, surgery): 0.08 in the rosuvastatin group and 0.16 in the placebo group (p = 0.03). This was also seen with the rates of deep-vein thrombosis (0.09 and 0.20, respectively; p = 0.004). There was no statistically significant difference between the 2 groups for unprovoked venous thromboembolism, pulmonary embolism, or bleeding episodes.

The JUPITER trial did not demonstrate a correlation between levels of high-density lipoprotein (HDL), LDL, total cholesterol, or triglycerides with the risk of venous thromboembolism. The authors do not believe the lipid-lowering effect of rosuvastatin is associated with the observed reduction in risk. Instead, statins can inhibit certain signaling proteins which leads to antithrombotic effects. The statin can also promote expression of thrombomodulin, which increases activity of the protein C anticoagulant pathway.

The authors conclude that “rosuvastatin was associated with a significant reduction in the risk of venous thromboembolism. This risk reduction appears to be an independent benefit of statin use, beyond the reduction in the risk of arterial thrombosis.” It appears there are more reasons to use statins than meets the eye … uh, heart.

  • Source
  • Glynn RJ, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Ridker PM. A randomized trial of rosuvastatin in the prevention of venous thromboembolism. N Engl J Med 2009;360:1851-61.