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Do HMG-CoA reductase inhibitors affect fibrinogen?
The Annals of Pharmacotherapy
|February 24, 2001
Summary
Hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors impact fibrinogen levels differently. Pravastatin decreases fibrinogen, while atorvastatin and lovastatin increase it, and simvastatin has a neutral effect.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Clinical Chemistry
Background:
- Fibrinogen is a key protein in blood coagulation.
- Elevated fibrinogen levels are associated with an increased risk of coronary artery disease.
- Hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are widely used to lower cholesterol.
Purpose of the Study:
- To review fibrinogen assay methods.
- To examine the link between fibrinogen and coronary artery disease risk.
- To assess the impact of HMG-CoA reductase inhibitors on fibrinogen levels.
Main Methods:
- Literature review of primary and review articles from MEDLINE (1966-1999).
- Evaluation of all identified relevant articles.
- Analysis of studies investigating the effects of atorvastatin, lovastatin, simvastatin, and pravastatin on fibrinogen.
Main Results:
- The Clauss method is the preferred assay for fibrinogen due to accuracy and precision.
- Atorvastatin and lovastatin were associated with significant increases in fibrinogen (22% and 24.4%, respectively) using immunonephelometric methods.
- Simvastatin showed a neutral effect on fibrinogen, while pravastatin led to significant decreases (7-19%).
Conclusions:
- Different HMG-CoA reductase inhibitors have varying effects on fibrinogen concentrations.
- Further research using direct comparisons and clotting assays is recommended to clarify these effects.