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Effect of high-dose statin therapy on coagulation factors: Lowering of factor XI as a modifier of fibrin clot properties in coronary artery disease.
- Source :
-
Vascular pharmacology [Vascul Pharmacol] 2023 Apr; Vol. 149, pp. 107153. Date of Electronic Publication: 2023 Feb 11. - Publication Year :
- 2023
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Abstract
- Background: Multiple pleiotropic effects of statins include antithrombotic properties with formation of looser fibrin networks more susceptible to lysis. Recently, rosuvastatin 20 mg/d has been reported to decrease coagulation factors (F) VII, FVIII and FXI in venous thrombosis patients.<br />Objectives: We investigated how high-dose statin therapy recommended in coronary artery disease (CAD) alters plasma levels of coagulation factors and if such changes might affect fibrin clot properties.<br />Methods: We studied 130 advanced CAD patients, who initially did not achieve the target low-density lipoprotein cholesterol (LDL-C). Before high-dose statin therapy (rosuvastatin 40 mg/d or atorvastatin 80 mg/d) and 6-12 months after its initiation, FII, FV, FVII, FVIII, FIX, FX, FXI and fibrinogen were assessed. We evaluated the impact of statin-induced alterations to the factors on plasma fibrin clot permeability (Ks) reflecting a fibrin pore size, and clot lysis time (CLT) reflecting fibrinolytic potential.<br />Results: At baseline LDL-C (median 3.2, interquartile range 2.7-3.7 mmol/L) was independently associated solely with FXI (β = 0.58, P < 0.001). Median LDL-C reduction by 25% (P < 0.001) on high-dose statin treatment was accompanied by lowering of FVII, FVIII, and FXI (for all P < 0.001). On high-dose statin treatment, Ks (R = 0.65, P < 0.001) inversely associated with CRP (β = -0.41, P < 0.001), LDL-C (β = -0.26, P = 0.001), and FXI (β = -0.18, P = 0.016). In turn, CLT (R = 0.45, P < 0.001) was positively associated with LDL-C (β = 0.19, P = 0.043) and FXI (β = 0.17, P = 0.049).<br />Conclusions: High-dose statin therapy in CAD patients decreases FVII, FVIII, and FXI. The statin-induced reduction in FXI may contribute to less prothrombotic fibrin clot phenotype, indicating additional antithrombotic effect of high-dose statins.<br />Competing Interests: Declaration of Competing Interest The authors of this manuscript have nothing to declare.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Fibrin
Factor XI
Fibrinolytic Agents
Cholesterol, LDL
Rosuvastatin Calcium adverse effects
Thrombin
Blood Coagulation Factors
Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects
Coronary Artery Disease diagnosis
Coronary Artery Disease drug therapy
Thrombosis diagnosis
Thrombosis drug therapy
Thrombosis prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1879-3649
- Volume :
- 149
- Database :
- MEDLINE
- Journal :
- Vascular pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 36774992
- Full Text :
- https://doi.org/10.1016/j.vph.2023.107153