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document
Improved fibrinolysis after 1-year treatment with HMG CoA reductase inhibitors in patients with coronary heart disease . The study was aimed to investigate the effect of two different statins on the levels of haemostatic variables reflecting procoagulant and fibrinolytic activity in patients with coronary heart disease ( CHD ) , with the hypothesis that statins might beneficially modify these levels . Fifty-eight patients were randomized to treatment with atorvastatin ( n=28 ) or simvastatin ( n=30 ) for 1 year . The starting dose in both groups was 20 mg/day . Fasting blood samples were collected before and after 12-month treatment for determinations of fibrinogen , prothrombin fragment 1+2 ( F1+2 ) , plasma D-dimer , soluble tissue factor , tissue plasminogen activator ( tPA ) antigen , tPA activity , plasminogen activator inhibitor type-1 activity ( PAI-1 activity ) and serum D-dimer as a global test of fibrinolytic activity . In the total population , improved fibrinolytic activity was observed after 1 year with increased levels of serum D-dimer ( P=.001 ) and tPA activity ( P=.024 ) and a reduction in tPA antigen ( P=.048 ) . No statistically significant changes were observed in any of the measured coagulation variables . Separately examined , an improved fibrinolytic profile was seen in the atorvastatin group with a significant increase in serum D-dimer ( P=.005 ) , a borderline increase in tPA activity ( P=.083 ) and a borderline reduction in tPA antigen ( P=.069 ) . Within the simvastatin group , a reduction in prothrombin F1+2 was observed ( P=.038 ) . The differences in changes between the groups were statistically significant only for global fibrinolysis ( serum D-dimer , P=.046 ) . In conclusion , an improved fibrinolytic profile was observed after statin treatment , most pronounced with atorvastatin . The results indicate that the drugs promote a profibrinolytic profile , and may in part explain the benefit of statin treatment rendered in the prevention of CHD .
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Intervention_Pharmacological
HMG CoA reductase inhibitors
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Intervention_Pharmacological
statins
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Intervention_Pharmacological
statins
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Intervention_Pharmacological
atorvastatin
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Intervention_Pharmacological
simvastatin
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Intervention_Pharmacological
atorvastatin
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Intervention_Pharmacological
simvastatin
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Intervention_Pharmacological
statin
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Intervention_Pharmacological
atorvastatin
9148
Intervention_Pharmacological
statin
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Outcome_Other
Fasting blood samples
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Outcome_Physical
fibrinogen
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Outcome_Physical
prothrombin fragment 1+2 ( F1+2 ) , plasma D-dimer
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Outcome_Physical
soluble tissue factor
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Outcome_Physical
tissue plasminogen activator ( tPA ) antigen
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Outcome_Physical
tPA activity
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Outcome_Physical
plasminogen activator inhibitor type-1 activity ( PAI-1 activity )
9156
Outcome_Physical
serum D-dimer as a global test of fibrinolytic activity
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Outcome_Physical
improved fibrinolytic activity
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Outcome_Physical
serum D-dimer
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Outcome_Physical
tPA activity
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Outcome_Physical
reduction in tPA antigen
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Outcome_Physical
increase in serum D-dimer
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Outcome_Physical
increase in tPA activity
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Outcome_Physical
reduction in tPA antigen
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Outcome_Physical
reduction in prothrombin F1+2
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Outcome_Physical
global fibrinolysis
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Outcome_Physical
fibrinolytic profile
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Participant_Condition
patients with coronary heart disease
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Participant_Condition
patients with coronary heart disease ( CHD )
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Participant_Sample-size
Fifty-eight patients