The Effects of 3-Month Rosuvastatin Adjuvant Therapy on Post Thrombotic Syndrome following Deep Vein Thrombosis; a Randomized Clinical Trial

Introduction:

Statins are known to have anticoagulation and anti-inflammatory effects. This study aimed to investi-gate the effect of Rosuvastatin in reduction of post thrombotic syndrome (PTS) following deep vein thrombosis (DVT).

In this randomized clinical trial, patients who were diagnosed with DVT of lower extremity were randomlyassigned to 4 treatment groups: group 1: Warfarin, group 2: Warfarin + Rosuvastatin, group 3: Rivaroxaban, and group 4:Rivaroxaban + Rosuvastatin. The treatments were followed for 3 months and prevalence of PTS (as primary outcome),as well as the changes in serum levels of D-dimer and C reactive protein (CRP), and the extent of thrombosis before andafter the intervention (as secondary outcomes) were compared between groups.

182 patients with the meanage of 55.22 ± 4.1 years finished the trial period (51.64% male). There was no significant difference between the groupsregarding the baseline characteristics. Based on the Brandjes score, 31 (17.03%) patients had PTS at the end of the study.The occurrence of PTS was significantly lower in the groups taking statins (p<0.0001). Although the change in the meandifference of legs circumference before and after intervention, were significant in all groups (p < 0.05), the differenceswas more prominent in groups 2 and 4 (p < 0.0001). After 3 months of taking medication, decrease of CRP was moreprominent in the statin groups (p = 0.001), and most cases with normal CRP were in statin groups. Among the patientswith the serum D-dimer level above 10000 ng/mL, patients in the statin groups experienced significantly more reduc-tion in D-dimer levels than the other groups (p<0.001).

Rosuvastatin administration in combination withrivaroxaban or warfarin significantly reduces the level of inflammatory factors including CRP and D-dimer, comparedto patients receiving anticoagulants alone. Rosuvastatin administration can significantly reduce the incidence of PTSand cause a difference in the size of the lower limbs within 3 months.