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Effect of atorvastatin on different fibrinolyis mechanisms in hypercholesterolemic subjects

F Bruni1, A L Pasqui, M Pastorelli

  • 1Department of Clinical Medicine and Immunological Sciences, Internal Medicine Division, Center for Metabolic Diseases and Atherosclerosis, University of Siena, Policlinico Le Scotte, V.le Bracci, 53100 Siena, Italy.

International Journal of Cardiology
|June 15, 2004
PubMed

Insights

Atorvastatin enhances fibrinolysis in hypercholesterolemic patients by improving platelet function and reducing thrombin generation. This occurs before significant cholesterol reduction, highlighting early vascular protective effects.

Area of Science:

  • Cardiovascular Pharmacology
  • Hemostasis and Thrombosis

Background:

  • Statins, including atorvastatin, offer cardiovascular benefits beyond lipid lowering.
  • Modulation of fibrinolysis is a key non-lipid-related action contributing to vascular protection.
  • Atorvastatin impacts platelet activity and thrombin generation, influencing fibrinolysis via thrombin activable fibrinolysis inhibitor (TAFI) in hypercholesterolemia.

Purpose of the Study:

  • To investigate atorvastatin's modulation of fibrinolysis.
  • To explore atorvastatin's interactions with endothelial mechanisms and thrombin generation.
  • To assess early effects of atorvastatin on coagulation and fibrinolysis markers.

Main Methods:

  • Study included 44 hypercholesterolemic subjects treated with atorvastatin (10 mg/day).
  • Evaluated markers included plasmin-antiplasmin complexes (PAP), tissue-plasminogen activator (t-PA), PAI-1, TAFI activity, platelet P-selectin, and thrombin generation.
  • Measurements were taken at baseline and at 7, 14, 28, and 90 days.

Main Results:

  • Hypercholesterolemic subjects showed reduced PAP at baseline, correlated with platelet markers and thrombin generation.
  • Atorvastatin increased PAP early in treatment, linked to improved platelet function and thrombin generation, preceding LDL-C reduction.
  • PAI-1 levels changed significantly later, correlating with LDL-C, VWF, and sE-selectin.

Conclusions:

  • Atorvastatin exhibits profibrinolytic activity in hypercholesterolemia.
  • This activity is initially mediated by positive effects on platelet function and thrombin generation.
  • TAFI activity plays a role in atorvastatin-induced modulation of fibrinolysis.
Abstract

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