多血症（PV）和原发性血小板增多症（ET）与心血管发病率和死亡率增加相关。降脂药物（statins）除了减少动脉血栓事件外，还可预防包括癌症患者在内的静脉血栓形成。之前的登记和索赔研究表明，statins的使用可能改善不同恶性肿瘤患者的生存期，因此我们评估了statins对老年PV和ET患者结局的影响。我们利用Surveillance, Epidemiology, and End Results-Medicare数据库，在老年人中识别出4010名PV（n=1809）和ET（n=2201）患者的基于人群的队列研究，其中中位随访时间为3.92（四分位数范围：2.58-5.75）年。采用倾向性评分匹配（PSM）和逆概率权重（IPTW）方法评估statins与总体生存率之间的潜在关联。利用多变量竞争风险模型，以死亡为竞争风险，评估了statins与血栓发生率之间可能的关系。55.8%的患者在PV/ET确诊后的第一年使用了statins，并且statins的使用与全因死亡率降低了22%（PSM：风险比[HR]=0.78，95%置信区间[CI]：0.63-0.98，p=0.03；IPTW：HR=0.79，95% CI：0.64-0.97，p=0.03）。在这一患者群体中，statins还降低了血栓风险（PSM：HR=0.63，95% CI：0.51-0.78，p<0.01；IPTW：HR=0.57，95% CI：0.49-0.66，p<0.01），包括在PV和ET亚组中。这些结果提示，在老年PV和ET患者的治疗策略中可能将statins纳入是重要的做法。© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Polycythemia vera (PV) and essential thrombocythemia (ET) are linked to increased risk of cardiovascular morbidity and mortality. In addition to the reduction in of arterial thrombotic events, statins may prevent venous thrombosis including among patients with cancer. As previous registry- and claims-based studies revealed that the use of statins may improve the survival of patients with various malignancies we evaluated their impact on outcomes of older adults with PV and ET.We identified 4010 older adults (aged 66-99 years at diagnosis) with PV (n = 1809) and ET (n = 2201) in a population-based cohort study using the Surveillance, Epidemiology, and End Results-Medicare database with median follow-up of 3.92 (interquartile range: 2.58-5.75) years. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) approaches were utilized to assess potential association between statins and overall survival. Multivariable competing risk models with death as a competing risk were used to evaluate possible relationship between statins and the incidence of thrombosis.55.8% of the patients used statins within the first year after PV/ET diagnosis, and statin use was associated with a 22% reduction in all-cause mortality (PSM: hazard ratio [HR] = 0.78, 95% confidence interval [CI]: 0.63-0.98, p = 0.03; IPTW: HR = 0.79, 95% CI: 0.64-0.97, p = 0.03). Statins also reduced the risk of thrombosis in this patient population (PSM: HR = 0.63, 95% CI: 0.51-0.78, p < 0.01; IPTW: HR = 0.57, 95% CI: 0.49-0.66, p < 0.01) as well as in PV and ET subgroups.These findings suggest that it may be important to incorporate statins into the therapeutic strategy for older adults with PV and ET.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.