Document Detail


Atorvastatin and quinapril inhibit blood coagulation in patients with coronary artery disease following 28 days of therapy.
MedLine Citation:
PMID:  16907931     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We evaluated the antithrombotic effects of statins and angiotensin-converting enzyme inhibitor (ACEI) drugs in patients with coronary artery disease (CAD). METHODS AND RESULTS: Blood coagulation at the site of microvascular injury was assessed in 26 males with CAD before and after treatment with quinapril (10 mg day-1; n=13) or atorvastatin (40 mg day-1; n=13) for 4 weeks and an additional 4 weeks of combined therapy (quinapril+atorvastatin). Rates of prothrombin and factor V activation (FVa), fibrinogen (Fbg) cleavage and FVa inactivation showed that both quinapril and atorvastatin decreased the rates of: formation of thrombin B-chain (by 30.6%, P=0.007; and by 34.3%, P=0.003), formation of thrombin-antithrombin complexes (by 30.4%, P=0.0002; and by 40%, P=0.001), FV activation (by 19.1%, P=0.03; and by 21.8%, P=0.005) and Fbg depletion (by 29.2%, P=0.004; and by 32.7%, P=0.001). Atorvastatin alone accelerated FVa inactivation (P=0.005). A further 4 weeks of combined therapy enhanced most anticoagulant effects only when atorvastatin was added to quinapril. CONCLUSIONS: In CAD patients, atorvastatin and quinapril slowed blood clotting at the site of microvascular injury after 28 days of therapy. Addition of atorvastatin to quinapril, but not quinapril to the statin, enhanced the anticoagulant effects. Our findings might help explain the reduced risk of myocardial infarction or stroke in patients treated with statins and/or ACEIs and the lack of clinical benefits from ACEI added to prior statin therapy in patients at cardiovascular risk.
Authors:
A Undas; K E Brummel-Ziedins; D P Potaczek; B Stobierska-Dzierzek; L Bryniarski; A Szczeklik; K G Mann
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-08-14
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  4     ISSN:  1538-7933     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-24     Completed Date:  2006-12-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  England    
Other Details:
Languages:  eng     Pagination:  2397-404     Citation Subset:  IM    
Affiliation:
Department of Medicine, Jagellonian University School of Medicine, Krakow, Poland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Anticholesteremic Agents / administration & dosage*
Blood Coagulation / drug effects*
Blood Coagulation Factors / analysis
Coronary Artery Disease / blood,  complications,  drug therapy*
Double-Blind Method
Evaluation Studies as Topic
Heptanoic Acids / administration & dosage*
Humans
Male
Middle Aged
Myocardial Infarction / blood,  etiology,  prevention & control
Pyrroles / administration & dosage*
Risk Factors
Stroke / blood,  etiology,  prevention & control
Tetrahydroisoquinolines / administration & dosage*
Time Factors
Grant Support
ID/Acronym/Agency:
HL-46703/HL/NHLBI NIH HHS; T32 HL-07594/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Anticholesteremic Agents; 0/Blood Coagulation Factors; 0/Heptanoic Acids; 0/Pyrroles; 0/Tetrahydroisoquinolines; 110862-48-1/atorvastatin; 82586-55-8/quinapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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