Effect of simultaneous use of oestrogens and statins on the risk for venous thromboembolism in post-menopausal women

Ruben Duijnhoven, Sophie Dell'Aniello, Christel Renoux, Vicky Tagalakis, Mirjam Knol, Olaf Klungel, Samy Suissa

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Abstract

Background: The effects that statins have on the risk for venous thromboembolism in perimenopausal women using hormone replacement therapy (HRT) is unknown. It has been hypothesised that simultaneous use of statins would lower the VTE risk associated with HRT. Objectives: In this study we assessed the effect of combined use of statins and HRT on the risk for VTE. Methods: We conducted a nested case-control study within a cohort of HRT users. The cohort consisted HRT users from the UK General Practice Research Database aged 50 to 79 years from the period 1 January 1987 to 1 March 2008. Exposure, outcomes, comedication and comorbidities were assessed for the time period before the index date. HRT was defined as oestrogens, combined oestrogens-progestogens, progestogens or tibolone. All cases of VTE during the selected period were identified and matched to controls on age, general practice, and year of entry of the general practice. Odds ratios were estimated using conditional logistic regression and the effect of separate and combined use of HRT and statins was modelled. The model was adjusted for the use of comedication and comorbities. Results: In total 23,505 cases were matched to 231,562 controls, from an initial cohort of 955,582 eligible women. All risks estimated are for users vs. non-users. For users of plain oestrogens and combination products (oestrogens and progestagens) who were not using statins, the adjusted ORs for VTE were estimated as 1.28 (1.19-1.39) and 1.49 (1.39-1.59) respectively, compared to non-users. When women used HRT together with statins, ORs of 1.40 (1.08-1.80) and 0.80 (0.57-1.14) were found for the risk of VTE associated with plain oestrogens and combination products. Conclusions: Our study suggests that the increased risk for VTE, which is associated with oestrogen-progestagen products, is lowered when they are used together with statins, but not so for oestrogen only.
Original languageEnglish
Pages (from-to)131-132
Number of pages2
JournalPharmacoepidemiology and Drug Safety
Volume20
DOIs
Publication statusPublished - 1 Aug 2011

Keywords

  • hydroxymethylglutaryl coenzyme A reductase inhibitor
  • gestagen
  • estrogen
  • tibolone
  • risk
  • female
  • human
  • venous thromboembolism
  • risk management
  • pharmacoepidemiology
  • general practice
  • data base
  • exposure
  • logistic regression analysis
  • model
  • hormone substitution
  • case control study
  • United Kingdom

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