Clinical Outcomes Associated with Statin Use in Pulmonary Embolism: A Systematic Review of Observational Studies.

Abstract

<b>Background</b>: Pulmonary embolism (PE) represents one of the most serious complications of venous thromboembolism (VTE). Conflicting studies indicate that statins could play a role in preventing recurrent VTE or improving survival in patients with PE. This review aims to assess the impact of statin use on clinical outcomes in patients with PE. <b>Methods</b>: A systematic search was conducted in PubMed and the Cochrane Library to identify studies evaluating the impact of statin therapy in patients with PE. The search covered all records from inception to 21 September 2025. Studies were deemed eligible if they included adult patients with PE, investigated statin and reported clinical outcomes such as mortality, recurrent PE, recurrent VTE, or deep vein thrombosis (DVT). The methodological quality of the included observational studies was assessed using the Newcastle-Ottawa Scale (NOS). <b>Results</b>: A total of twelve observational studies were included; sample sizes ranged from fewer than 400 patients to nearly 200,000, with follow-up durations spanning from 30 days to more than 5 years. Statin use was associated with reduced short-term and all-cause mortality in large registry analyses, though smaller studies showed no difference. Most cohorts reported lower VTE recurrence among statin users, with some variation across settings. Overall, evidence suggests a potential benefit of statins in reducing mortality and VTE recurrence in patients with pulmonary embolism. <b>Conclusions</b>: Real-world data suggest that statin therapy may reduce both short-term mortality and VTE recurrence following PE, though findings vary depending on study quality and population characteristics. Larger prospective studies are required to confirm these findings.