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Published on: November 10, 2017
Similar effects of atorvastatin, simvastatin and pravastatin on thrombogenic and inflammatory parameters in patients
C Joukhadar1, N Klein, M Prinz
1Department of Clinical Pharmacology, University of Vienna Medical School, Austria.
Insights
This study found that atorvastatin, simvastatin, and pravastatin similarly affected hemostatic and inflammatory markers in hypercholesterolemic patients over three months. These findings suggest that chemical and pharmacological differences between statins do not significantly impact these markers.
Area of Science:
- Cardiovascular Pharmacology
- Lipid Metabolism and Atherosclerosis
- Hemostasis and Thrombosis Research
Background:
- Statins offer cardiovascular benefits beyond lipid reduction, potentially through effects on thrombosis, inflammation, plaque stability, and endothelial function.
- The specific impact of different statins on these non-lipid-lowering effects remains incompletely understood.
Purpose of the Study:
- To compare the short-term effects of three distinct statins (atorvastatin, simvastatin, pravastatin) on hemostatic and inflammatory markers.
- To determine if chemical and pharmacokinetic differences influence these non-lipid-lowering effects.
Main Methods:
- A randomized, double-blind, controlled study involving 99 hypercholesterolemic patients.
- Patients received nearly equieffective cholesterol-lowering doses of atorvastatin, simvastatin, or pravastatin for three months.
- Measurements included plasma levels of von Willebrand factor antigen (vWf-Ag), fibrinogen, d-dimer, prothrombin fragment 1+2 (F1.2), and C-reactive protein (CRP).
Main Results:
- All statins significantly reduced total plasma cholesterol by 22-29%.
- No significant differences were observed in the effects of the three statins on F1.2, vWf-Ag, d-dimer, and CRP.
- Simvastatin showed a more pronounced effect on fibrinogen compared to atorvastatin and pravastatin, though F1.2 and vWf-Ag were reduced across all statins when data were pooled.
Conclusions:
- Short-term (3-month) treatment with atorvastatin, simvastatin, and pravastatin demonstrated similar effects on selected hemostatic and inflammatory plasma markers in hypercholesterolemic patients.
- The chemical and pharmacological variations among these statins do not appear to exert a major influence on these specific markers.
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 short-term (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.
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