Similar Effects of Atorvastatin, Simvastatin and Pravastatin on Thrombogenic and Inflammatory Parameters in Patients with Hypercholesterolemia

Christian Joukhadar; Nikolas Klein; Mojgan Prinz; Claudia Schrolnberger; Thomas Vukovich; Michael Wolzt; Leopold Schmetterer; Guido T. Dorner

doi:10.1055/s-0037-1612902

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2001; 85(01): 47-51
DOI: 10.1055/s-0037-1612902

Review Article

Schattauer GmbH

Similar Effects of Atorvastatin, Simvastatin and Pravastatin on Thrombogenic and Inflammatory Parameters in Patients with Hypercholesterolemia

Christian Joukhadar

¹Department of Clinical Pharmacology, Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

,

Nikolas Klein

¹Department of Clinical Pharmacology, Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

,

Mojgan Prinz

²Clinical Institute of Medical and Chemical Laboratory Diagnostics, Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

,

Claudia Schrolnberger

¹Department of Clinical Pharmacology, Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

,

Thomas Vukovich

²Clinical Institute of Medical and Chemical Laboratory Diagnostics, Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

,

Michael Wolzt

¹Department of Clinical Pharmacology, Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

,

Leopold Schmetterer

¹Department of Clinical Pharmacology, Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

³Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

,

Guido T. Dorner

¹Department of Clinical Pharmacology, Institute of Medical Physics, University of Vienna Medical School, Vienna, Austria

› Author Affiliations

Abstract

Summary

Background: Previous studies have suggested that statins exert beneficial effects beyond their favorable lipid lowering effect. Particularly, the modification of thrombus formation and degradation, alteration in inflammatory response, plaque stabilization and improved endothelial function are thought to be responsible for additional reduction of morbidity and mortality due to cardiovascular events. To date, however, it is still unclear whether these effects are elicited by all statins. Methods and Results: We set out to compare in a controlled, randomized, double-blind study design the effects of almost equieffective cholesterol lowering doses of three chemically and pharmacokinetically different statins (atorvastatin, simvastatin, pravastatin) on hemostatic and inflammatory markers in 99 hypercholesterolemic patients. At entry and 3 months after onset of statin therapy plasma cholesterol and von Willebrand factor antigen (vWf-Ag), fibrinogen, d-dimer, prothrombin fragment 1+2 (F1.2) and C-reactive protein (CRP) were measured. The effect on plasma values of F1.2, vWf-Ag, d-dimer and CRP was not significantly different between the three treatment groups. The effect of simvastatin on fibrinogen (p = 0.005) was more pronounced than the effects of atorvastatin (p = 0.48 n.s.) and pravastatin (p = 0.15 n.s.). Plasma levels of F1.2 and vWf-Ag (when data of all statins were pooled) were significantly reduced by 7% and 10% versus baseline, respectively. No significant reduction was observed for d-dimer (p = 0.26) and CRP (p = 0.5). Total plasma cholesterol levels decreased significantly (p <0.0001 in all groups) between 22% and 29% compared to baseline. Conclusion: The present study shows similar shortterm (3 months) effects of atorvastatin, simvastatin and pravastatin on selected hemostatic and inflammatory parameters in plasma in patients with hypercholesterolemia. Thus, chemical and pharmacological differences between statins appear to exert no major influence on these parameters.

Keywords

HMG-CoA reductase inhibitor - C-reactive protein - hemostatic factors

Full Text

References

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