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Time‐dependent effect of statins on platelet function in hypercholesterolaemia
Author(s) -
Puccetti L.,
Pasqui A. L.,
Pastorelli M.,
Bova G.,
Cercignani M.,
Palazzuoli A.,
Angori P.,
Auteri A.,
Bruni F.
Publication year - 2002
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.2002.01086.x
Subject(s) - pravastatin , simvastatin , fluvastatin , atorvastatin , platelet , medicine , endocrinology , statin , hmg coa reductase , platelet activation , cholesterol , chemistry , pharmacology , reductase , biochemistry , enzyme
Background Reduction of platelet activity induced by statins has been described as a positive effect exerted by such molecules on vascular thrombotic events. However, the relations among cholesterol (LDL‐C) reduction, the timing of the antiplatelet effect, the involved mechanisms and the doses of each statin able to reduce platelet function are not actually well known. The aim of our study was to evaluate the impact of simvastatin (20 mg day −1 ), atorvastatin (10 mg day −1 ), fluvastatin (40 mg day −1 ) and pravastatin (40 mg day −1 ) on platelet function in hypercholesterolaemic subjects with relation to (LDL‐C), oxidized‐LDL (ox‐LDL) and antiport mechanism modifications. Materials and methods Sixteen subjects were assigned to each treatment (40 males, 24 females, mean age 48·7 ± 13·4, LDL‐C 5·13 ± 0,23 mmol L −1 ) and evaluated for platelet surface P‐selectin (P‐sel), lipid profile, ox‐LDL, platelet‐associated ox‐LDL (Pox‐LDL), platelet cholesterol content, antiport mechanisms, and intracellular and systemic NO synthase every 7 days for one month. Results Our data show a strong relation between enhanced P‐sel and Pox‐LDL ( r = 0·68, P < 0·01). Simvastatin, atorvastatin, fluvastatin and pravastatin reduce platelet activity after 1, 2, 3 and 4 weeks of treatment, respectively ( P < 0·001, P < 0·001, P < 0·01, P < 0·05). Pox‐LDL are modulated early by simvastatin, atorvastatin and fluvastatin Pox‐LDL ( r = 0·66, 0·65 and 0·52; P < 0·001, 0·001 and 0·01, respectively) whereas LDL‐C and ox‐LDL reductions associated to modifications of antiport activity act later. Moreouer, they are the most relevant finding in pravastatin‐related subjects. Conclusions Our data suggest a different impact of several statins on platelet function, which is initially related to interference with Pox‐LDL rather than LDL‐C reduction.