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Comparative study of HMG-CoA reductase inhibitors on fibrinogen
R S Rosenson1, C C Tangney, E J Schaefer
1Preventive Cardiology Center, Lipoprotein and Hemorheology Research Facility, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA. rrosenso@rush.edu
Insights
This study found no significant differences in fibrinogen levels between patients treated with atorvastatin and other statins. These findings suggest statin type does not impact fibrinogen levels, a factor in cardiovascular events.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Fibrinogen levels can vary with statin use, potentially influencing cardiovascular events.
- Understanding these variations is crucial for managing coronary heart disease (CHD).
Purpose of the Study:
- To compare changes in fibrinogen levels between atorvastatin and other statins in CHD patients.
- To investigate the impact of different statin therapies on fibrinogen concentrations.
Main Methods:
- A randomized, placebo-controlled crossover study involving adult CHD patients.
- Patients received atorvastatin 80 mg or other statins (fluvastatin, lovastatin, pravastatin, simvastatin) for 12 weeks each.
- Fibrinogen levels were measured using an automated Clauss method with stringent pre-analytical and analytical controls.
Main Results:
- No statistically significant differences in fibrinogen levels were observed between the atorvastatin and other statin treatment groups.
- Rigorous measurement techniques minimized variability, ensuring reliable fibrinogen level assessment.
Conclusions:
- The type of statin used (atorvastatin vs. other statins) does not appear to significantly alter fibrinogen levels in coronary heart disease patients.
- These findings indicate that statin-induced changes in fibrinogen are unlikely to be a major differentiating factor in cardiovascular event risk among different statin therapies.
Abstract:
Statins have a variable response on fibrinogen, and these changes may have implications on cardiovascular events. In this randomized placebo-controlled crossover study, we evaluated whether changes in fibrinogen levels were different between atorvastatin and other statin-treated patients. Adult coronary heart disease (CHD) patients aged 39-83 years with LDL cholesterol levels > or = 130 mg/dl were randomized to atorvastatin 80 mg (n = 84) and one of the following statins: fluvastatin 80 mg (n = 23), lovastatin 80 mg (n = 20), pravastatin 40 mg (n = 22) or simvastatin 40 mg (n = 20) each for 12 weeks in either order. Fibrinogen was analyzed by an automated method of Clauss. Three independently acquired samples were obtained within 1 min of tourniquet application, and each specimen was measured in duplicate. Statistical analyses were performed using a mixed model repeated measures analysis of variance procedure with SAS version 6.12. There were no significant changes in fibrinogen between treatment groups. This study evaluated changes in fibrinogen with established pre-analytical and analytical procedures known to minimize variability in fibrinogen measurement, and we did not observe any differences in fibrinogen levels in the treatment groups.