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document
Atorvastatin and quinapril inhibit blood coagulation in patients with coronary artery disease following 28 days of therapy . BACKGROUND We evaluated the antithrombotic effects of statins and angiotensin-converting enzyme inhibitor ( ACEI ) drugs in patients with coronary artery disease ( CAD ) . METHODS AND RESULTS Blood coagulation at the site of microvascular injury was assessed in 26 males with CAD before and after treatment with quinapril ( 10 mg day-1 ; n=13 ) or atorvastatin ( 40 mg day-1 ; n=13 ) for 4 weeks and an additional 4 weeks of combined therapy ( quinapril+atorvastatin ) . Rates of prothrombin and factor V activation ( FVa ) , fibrinogen ( Fbg ) cleavage and FVa inactivation showed that both quinapril and atorvastatin decreased the rates of : formation of thrombin B-chain ( by 30.6 % , P=0.007 ; and by 34.3 % , P=0.003 ) , formation of thrombin-antithrombin complexes ( by 30.4 % , P=0.0002 ; and by 40 % , P=0.001 ) , FV activation ( by 19.1 % , P=0.03 ; and by 21.8 % , P=0.005 ) and Fbg depletion ( by 29.2 % , P=0.004 ; and by 32.7 % , P=0.001 ) . Atorvastatin alone accelerated FVa inactivation ( P=0.005 ) . A further 4 weeks of combined therapy enhanced most anticoagulant effects only when atorvastatin was added to quinapril . CONCLUSIONS In CAD patients , atorvastatin and quinapril slowed blood clotting at the site of microvascular injury after 28 days of therapy . Addition of atorvastatin to quinapril , but not quinapril to the statin , enhanced the anticoagulant effects . Our findings might help explain the reduced risk of myocardial infarction or stroke in patients treated with statins and/or ACEIs and the lack of clinical benefits from ACEI added to prior statin therapy in patients at cardiovascular risk .
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Intervention_Pharmacological
Atorvastatin
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
statins
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Intervention_Pharmacological
angiotensin-converting enzyme inhibitor ( ACEI ) drugs
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
atorvastatin
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Intervention_Pharmacological
atorvastatin
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
quinapril
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Intervention_Pharmacological
statin
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Intervention_Pharmacological
statins
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Outcome_Physical
Rates of prothrombin and factor V activation ( FVa )
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Outcome_Physical
fibrinogen ( Fbg ) cleavage
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Outcome_Physical
FVa inactivation
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Outcome_Physical
formation of thrombin B-chain
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Outcome_Physical
formation of thrombin-antithrombin complexes
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Outcome_Physical
FV activation
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Outcome_Physical
Fbg depletion
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Outcome_Physical
FVa inactivation
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Outcome_Physical
anticoagulant effects
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Participant_Condition
patients with coronary artery disease
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Participant_Condition
patients with coronary artery disease ( CAD )
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Participant_Sample-size
26
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Participant_Sex
males
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Participant_Condition
CAD patients