Statins, inflammation and deep vein thrombosis: a systematic review.
Statins, inflammation and deep vein thrombosis: a systematic review.
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DOI：
10.1007/s11239-012-0687-9
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发表时间：
2012-05
影响因子：
4
通讯作者：
Diaz JA
中科院分区：
文献类型：
--
作者：
Rodriguez AL;Wojcik BM;Wrobleski SK;Myers DD Jr;Wakefield TW;Diaz JA
静脉血栓栓塞（VTE）包括深静脉血栓形成（DVT）和肺栓塞。2009年JUPITER试验显示，在C反应蛋白（CRP）水平升高的非高血压患者中，接受瑞舒伐他汀治疗后DVT显著降低。他汀类药物对血栓形成的影响尚不清楚，促使此文献综述。使用MEDLINE、EMBASE和PUBMED数据库进行文献检索（1950年至2011年2月），包括以下关键词：“他汀类药物”、“羟甲基戊二酰辅酶A还原酶抑制剂”、“VTE”、“PE”、“DVT”以及“抗凝”或“炎症”。排除社论、综述、病例报告、荟萃分析和重复。DVT的炎症生物标志物包括白细胞介素（IL）-6，CRP，IL-8和单核细胞趋化蛋白1（MCP-1）。他汀类药物治疗可降低CRP和MCP-1的IL-6表达，通常在VTE中升高。IL-6诱导的MCP-1的减少与静脉壁纤维化、促进血栓后综合征（PTS）和患者中的复发性DVT有关。此外，我们的审查表明，抗血栓形成的影响可能是通过他汀类药物的抗炎特性。这项工作支持他汀类药物治疗有能力降低VTE的发生率和复发率，并有可能减少PTS。这主要是由于他汀类药物的抗炎作用，也可以解释为什么CRP升高的血脂正常患者的VTE减少最多。鉴于其出血风险低，他汀类药物有可能作为一种安全的替代药物治疗，以目前的治疗在选定的VTE患者，但进一步研究这一概念是必要的。
Venous thromboembolism (VTE) includes both deep vein thrombosis (DVT) and pulmonary embolism. The 2009 JUPITER trial showed a significant decrease in DVT in non-hyperlipidemic patients, with elevated C-reactive protein (CRP) levels, treated with rosuvastatin. The effects of statins on thrombosis are unclear, prompting this literature review. A literature search was performed (1950 to February 2011) with MEDLINE, EMBASE, and PUBMED databases including the following keywords: “statins”, “hydroxymethylglutaryl-CoA reductase inhibitors”, “VTE”, “PE”, “DVT”, and either “anti-coagulation” or “inflammation”. Editorials, reviews, case reports, meta-analysis and duplicates were excluded. Inflammatory biomarkers of DVT, include interleukin (IL)-6, CRP, IL-8, and monocyte chemotactic protein 1 (MCP-1). Statin therapy reduces IL-6 expression of CRP and MCP-1, usually elevated in VTE. Reduction of IL-6 induced MCP-1 has been linked to vein wall fibrosis, promoting post thrombotic syndrome (PTS) and recurrent DVT in patients. Also, our review suggests that the anti-thrombotic effects are likely exhibited through the anti-inflammatory properties of statins. This work supports that statin therapy has the ability to decrease the incidence and recurrence of VTE and the potential to decrease PTS. This is mainly due to the anti-inflammatory effects of statins and may explain why normolipidemic patients, with elevated CRP, appear to have the greatest reduction in VTE. Given their low risk of bleeding, statins have the potential to serve as a safe adjunctive pharmacological therapy to current treatments in select patients with VTE, however further investigations into this concept are needed and essential.
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DOI：
10.1177/1076029611405032
发表时间：
2011-08
期刊：
Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
影响因子：
--
作者：
Ramacciotti E;Blackburn S;Hawley AE;Vandy F;Ballard-Lipka N;Stabler C;Baker N;Guire KE;Rectenwald JE;Henke PK;Myers DD Jr;Wakefield TW
通讯作者：
Wakefield TW
影响因子：
3.3
作者：
Nishino, Masami;Hoshida, Shiro;Yamada, Yoshio
通讯作者：
Yamada, Yoshio
影响因子：
4
作者：
Ashrani, Aneel A.;Heit, John A.
通讯作者：
Heit, John A.
影响因子：
120.7
作者：
Albert, MA;Danielson, E;Ridker, PM
通讯作者：
Ridker, PM
影响因子：
6.7
作者：
Meier, Thomas R.;Myers, Daniel D., Jr.;Wakefield, Thomas W.
通讯作者：
Wakefield, Thomas W.