医学
血栓后综合征
荟萃分析
内科学
深静脉
血栓形成
事件(粒子物理)
重症监护医学
物理
量子力学
作者
Lucia Caiano,Taylor Drury,Amin Zahrai,Tzu‐Fei Wang,Deborah Siegal,Marc Rodger,Karine Fournier,Aurélien Delluc
标识
DOI:10.1016/j.jtha.2022.12.008
摘要
Background Post-thrombotic syndrome (PTS) is the most frequent long-term complication of deep vein thrombosis. Apart from anticoagulation, there are no medications, procedures, devices, or lifestyle changes that effectively prevent PTS. There is a growing interest in the potential protective effects of statins for the prevention of PTS. Objective To conduct a systematic review and meta-analysis on the role of statins to prevent PTS after a DVT event. Methods We searched the MEDLINE(R) ALL, Embase, Cochrane Central Register of Controlled Trials, and Scopus from inception to April 5, 2022. The main concepts searched were “statins” and “post thrombotic syndrome.” There was no language restriction. The main outcome measure was the incidence rate ratio (IRR) for PTS associated with exposure to statins. Results Of 1971 screened records, 5 studies were included in the meta-analysis (2 retrospective cohorts and 3 randomized controlled trials [RCTs]). The pooled incidence of PTS was 34.8% per patient-year (95% CI, 9.5–127.4) in patients receiving a statin and 41.6% per patient-year (95% CI, 13.2–132) in controls. Exposure to statins was associated with a significantly decreased risk of PTS (IRR, 0.78; 95% CI, 0.63–0.96, I2 = 0%). Meta-analysis of the 2 retrospective cohorts found a significant reduction in the risk of developing PTS (IRR, 0.68; 95% CI, 0.51–0.91), whereas meta-analysis of RCTs showed no reduction in PTS occurrence (IRR, 0.92; 95% CI, 0.68–1.25). Conclusions Although this systematic review suggests that statins may reduce PTS incidence by 22% after deep vein thrombosis, meta-analysis of RCTs showed no risk reduction. Confirmation of the efficacy of statins on the prevention of PTS should be assessed in larger RCTs.
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