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Statins, aspirin and risk of venous thromboembolic events in breast cancer patients

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Abstract

Venous thromboembolic events (VTE’s) are associated with decreased survival in breast cancer patients. Studies suggested that statins reduce the risk of VTE’s in the general population. Low dose Aspirin reduces risk of VTE’s in high risk populations. The Breast Cancer in Northern Israel Study is a case–control study of consecutive breast cancer cases diagnosed in northern Israel and matched controls. The present analysis was limited to cases with breast cancer enrolled in the study. Data was extracted from Clalit Health Services (CHS) database and from computerized pharmacy records. Out of 3,585 patients enrolled, 261 (7.3 %) had a VTE during median follow up of 4.2 years. The 1 and 2 year cumulative incidence was 2.64 and 3.65 %. 55.7 % of patients used statins, predominantly simvastatin (75.8 %). 44.5 % used aspirin. In multivariate analysis neither statins nor aspirin use was associated with a reduced risk for a VTE. Unadjusted HR for statin and aspirin was 1.461 (1.018–2.096) and 1.293 (0.846–1.976), respectively, and the adjusted HR were 0.86 (0.648–1.14) and 1.013 (0.737–1.392). Results were similar when only simvastatin use was assessed. Metastatic disease, chemotherapy, age, BMI and presence of comorbidities were significantly associated with risk of VTE’s. Our study is the first to look at the effect of statins and aspirin on the incidence of VTE’s in patients with breast cancer. In our cohort, statin and aspirin use did not decrease the risk for a VTE. Our results might be explained by use of low potency statins (simvastatin and pravastatin) and by alternate mechanisms for VTE formation in patients with cancer.

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Authors and Affiliations

  1. Department of Oncology, Clalit Health Services, Lin and Carmel Medical Centers, 35 Rotchild St., Haifa, Israel

    Ayelet Shai, Mariana Steiner & Shoshana Keren

  2. Department of Community Medicine and Epidemiology and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Michal St. 7, Haifa, Israel

    Hedy S. Rennert & Gad Rennert

  3. Gynecology – Oncology Unit, Department of Obstetrics and Gynecology and Bruce Rappaport Faculty of Medicine, Carmel Medical Center and Technion-Israel Institute of Technology, Michal St. 7, Haifa, Israel

    Ofer Lavie

  4. Hematology Unit, Carmel Medical Center, Michal St. 7, Haifa, Israel

    Muona Ballan-Haj

  5. Department of Surgery A, Carmel Medical Center, Michal St. 7, Haifa, Israel

    Arie Bitterman

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  1. Ayelet Shai
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Correspondence to Ayelet Shai.

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Shai, A., Rennert, H.S., Lavie, O. et al. Statins, aspirin and risk of venous thromboembolic events in breast cancer patients. J Thromb Thrombolysis 38, 32–38 (2014). https://doi.org/10.1007/s11239-013-1015-8

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