Benefits from statins in anticoagulated venous thromboembolism patients: recent advances

Venous thromboembolism (VTE), encompassing deep vein thrombosis and pulmonary embolism, remains a major cause of morbidity and mortality worldwide. Although oral anticoagulation is the cornerstone of VTE treatment, recurrent events and long‑term complications, such as post‑thrombotic syndrome, persist in a significant proportion of patients. Recent evidence suggests that statins, traditionally used for lipid‑lowering therapy, may exert pleiotropic beneficial effects in patients with VTE, particularly those already receiving anticoagulants. These benefits include anti‑inflammatory, antithrombotic (eg, anticoagulant, antiplatelet, and profibrinolytic actions), endothelial‑stabilizing, and immunomodulatory properties. Clinical and observational studies have highlighted that statin use is associated with reduced risk of recurrent VTE and improved survival, even in the absence of hyperlipidemia. This review synthesizes the current evidence on the role of statins in anticoagulated patients with VTE, exploring mechanistic insights, clinical trial data, and real‑world findings. We also discuss the potential synergistic effects between statins and anticoagulants, as well as safety considerations, particularly in elderly and polymedicated populations. Furthermore, we address the limitations of existing studies and outline future research directions to establish whether statins should be systematically considered in secondary prevention strategies for VTE. In conclusion, statins appear to confer significant adjunctive benefits in anticoagulated VTE patients, with an acceptable safety profile. Integration of statins into VTE management may represent a cost‑effective and widely accessible intervention to enhance patient outcomes, though prospective randomized controlled trials are still needed to confirm causality and determine the optimal use.