Document Detail


Simvastatin increases clot permeability and susceptibility to lysis in patients with LDL cholesterol below 3.4 mmol/l.
MedLine Citation:
PMID:  19694216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Statins produce additional beneficial effects, including attenuation of prothrombotic mechanisms. In patients at high cardiovascular risk, who have markedly elevated low-density lipoprotein (LDL) cholesterol levels, simvastatin can reduce thrombin generation. Moreover, we have described simvastatin-induced improvement of fibrin clot properties, the formation of which represents the final step of blood coagulation. OBJECTIVES: The aim of the present study was to assess the effect of simvastatin on fibrin features observed in subjects with LDL cholesterol <3.4 mmol/l. PATIENTS AND METHODS: Thirty subjects (24M, 6F) aged <70 years with LDL cholesterol <3.4 mmol/l with no history of cardiovascular events were enrolled in the study. Patients were excluded if they had diabetes mellitus, chronic inflammatory diseases and renal insufficiency. Prior to and following a 3-month treatment with simvastatin (40 mg/d), ex vivo plasma fibrin clot permeability and efficiency of clot lysis were measured. RESULTS: Simvastatin led to a significant decrease in total cholesterol, LDL cholesterol, triglycerides and C-reactive protein (CRP), while fibrinogen levels remained unaltered. There were posttreatment increase in clot permeability by 4.4% (p<0.001) and shortening of clot lysis by 11.2% (p<0.001) compared to pretreatment values. These changes were correlated with reduction in CRP following simvastatin. Simvastatin-induced increase in clot permeability was associated only with age and decrease in CRP levels (R2 for the model = 0.61), while shortening of clot lysis time observed following simvastatin use was predicted only by reduction of triglycerides and CRP (R2 for the model = 0.62). CONCLUSIONS: Simvastatin exerts unique properties involving enhanced fibrin clot lysis and increased clot permeability in subjects with LDL cholesterol <3.4 mmol/l, which is associated with its anti-inflammatory effects. Altered fibrin clot function might contribute to clinical benefits of statins.
Authors:
Anetta Undas; Roman Top?r-Madry; Wies?awa Tracz
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewn?trznej     Volume:  119     ISSN:  0032-3772     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-08-21     Completed Date:  2009-09-17     Revised Date:  2010-04-01    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  354-9     Citation Subset:  IM    
Affiliation:
Institute of Cardiology, Jagiellonian University School of Medicine, Krak?w, Poland. mmundas@cyf-kr.edu.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticholesteremic Agents / administration & dosage*
C-Reactive Protein / drug effects
Cholesterol, LDL / blood*,  drug effects
Dose-Response Relationship, Drug
Female
Fibrinolysis / drug effects*
Humans
Hypercholesterolemia / blood,  drug therapy*
Male
Middle Aged
Permeability
Simvastatin / administration & dosage*
Thrombosis / blood,  drug therapy*
Treatment Outcome
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Cholesterol, LDL; 0/Triglycerides; 79902-63-9/Simvastatin; 9007-41-4/C-Reactive Protein

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