Effect of Atorvastatin on Haemostasis, Fibrinolysis and Inflammation in Normocholesterolaemic Patients with Coronary Artery Disease: a Post Hoc Analysis of Data from a Prospective, Randomized, Double-blind Study
Overview
Authors
Affiliations
Background: Treatment with HMG-CoA reductase inhibitors (statins) reduces the morbidity and mortality of coronary artery disease (CAD). In addition to their lipid-lowering actions, pleiotropic effects of statins have been demonstrated.
Objective: The aim of the present study was to assess if atorvastatin therapy has an impact on haemostasis, fibrinolysis and inflammation in normocholesterolaemic patients with CAD.
Methods: Fifty-four patients with CAD who had received atorvastatin treatment for at least 8 weeks (mean dosage 30 mg/day) and 54 patients with CAD who had not received atorvastatin therapy were selected from a larger prospective, randomized, double-blind study for inclusion in this post hoc analysis. Patients were matched by their total cholesterol levels. All patients were normocholesterolaemic.
Results: In the atorvastatin-treated patients significantly lower plasma levels of thrombin-antithrombin complexes (p < 0.05), plasminogen activator inhibitor-1 activity (PAI-1) [p < 0.05], soluble vascular cell adhesion molecule-1 (p < 0.05), soluble platelet selectin (p < 0.05) and high-sensitivity C-reactive protein (p < 0.05) were measured compared with patients not on atorvastatin therapy. Additionally, a strong trend towards lower soluble intercellular adhesion molecule-1 plasma levels was detected in patients treated with atorvastatin. No differences were found in tissue-type plasminogen activator antigen, plasmin-plasmin inhibitor complexes, fibrinogen, D-dimer and activated factor XII values.
Conclusion: Atorvastatin appears to have an effect on coagulation activation, fibrinolysis and inflammation in patients with CAD. Reduction in PAI-1 and reduced thrombin formation may have an impact on cardiovascular morbidity and mortality in patients with CAD.
Jiang Y, Liu N, Han J, Li Y, Spencer P, Vodovoz S Transl Stroke Res. 2020; 12(3):416-427.
PMID: 33140258 DOI: 10.1007/s12975-020-00872-3.
Clinical effects of antiplatelet drugs and statins on D-dimer levels.
Schol-Gelok S, van der Hulle T, Biedermann J, van Gelder T, Klok F, van der Pol L Eur J Clin Invest. 2018; 48(7):e12944.
PMID: 29682728 PMC: 6055760. DOI: 10.1111/eci.12944.
Anti-inflammatory and anti-thrombogenic effects of atorvastatin in acute ischemic stroke.
Min L, Shao S, Wu X, Cong L, Liu P, Zhao H Neural Regen Res. 2014; 8(23):2144-54.
PMID: 25206523 PMC: 4146119. DOI: 10.3969/j.issn.1673-5374.2013.23.004.
Adams N, Lutsey P, Folsom A, Herrington D, Sibley C, Zakai N J Thromb Haemost. 2013; 11(6):1078-84.
PMID: 23565981 PMC: 3702638. DOI: 10.1111/jth.12223.
Plasminogen activator inhibitor-1 and thrombotic cerebrovascular diseases.
Tjarnlund-Wolf A, Brogren H, Lo E, Wang X Stroke. 2012; 43(10):2833-9.
PMID: 22879095 PMC: 3712849. DOI: 10.1161/STROKEAHA.111.622217.