A Dose of Medical News #1.1 - Rosuvastatin in Prevention of VTE

Over the last few years, there have been postulations about the connection between venous and arterial clotting mechanism. It was thought although the end product is the same, the precipitant may be different. Platelet activation for arterial and stasis for venous. This led to the use of aspirin - an antiplatelet agent - in treatment of ischaemic heart disease and stroke, both due to clots in the arterial system. In the treatment of deep vein thrombosis (DVT)  - economy class syndrome - and pulmonary embolism, a condition that can kill.

Researchers based in Harvard has published a paper recently using an agent previously exclusive used to prevent arterial thrombosis in prophylaxis against DVT and PE. The team collected data on 17000 healthy subjects taking a cholesterol-lowering agent Rosuvastatin, and basically see what happens to them in a period of many months. The results showed that the group taking Rosuvastatin significantly developed less episode of DVT compared to their matched counterparts taking placebo. Unfortunately there were no difference in the incidence of pulmonary embolism.

The result is clearly positive but I have yet to ascertain its impact on general practice. The usual measure used to prevent clots during surgery is to give a dose of heparin to the patient. This has clearly reduced the risk of DVT and PE for those undergoing surgery. This study I am sure is looking at a different setting. Unfortunately statin is not without its side-effects and I cannot justify putting my patients on it just for prevention of DVT especially if the benefit can only be seen after many months. However with all this study, it is the pattern of effect that is more important. I am sure there will be a more direct comparison of this drug maybe at a different dosing against the already established heparin because the main advantage of this agent is, there is no risk of bleeding that we often encounter with the use of heparin.