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January 1, 2015Archives of Medical Science40 citationsOpen Access

The influence of statin therapy on platelet activity markers in hyperlipidemic patients after ischemic stroke

MPMałgorzata PawelczykMedical University of LodzHCH ChmielewskiMilitary Medical AcademyBKBeata KaczorowskaMedical University of Lodz

Key Result

Simvastatin therapy (20 mg/day) for 6 months in hyperlipidemic patients after ischemic stroke significantly reduced the percentage of resting CD62P(+) platelets from 2.72% to 1.09%.

Study Design

Type

Observational (n=41)

Multicenter

No

Structured PICO

Does simvastatin reduce platelet activation markers in hyperlipidemic patients after ischemic stroke?

P
Population
41 participants, including 21 hyperlipidemic patients at least 3 months post-ischemic stroke and 20 healthy controls, evaluated for platelet activation markers before and after 6 months of simvastatin therapy.
I
Intervention
Simvastatin 20 mg/day oral for 6 months, added to standard therapy (aspirin 75 mg/day, antihypertensives, neuroprotective drugs).
C
Comparator
Baseline values (before simvastatin treatment) and 20 healthy age- and sex-matched control subjects.
O
Outcome
Platelet activation markers (platelet CD62P expression on resting and thrombin-activated platelets, sP-selectin serum levels, and platelet-derived microparticles [PDMPs]) at 6 months.surrogate

Simvastatin therapy in hyperlipidemic patients after ischemic stroke significantly reduces platelet activation markers, suggesting a pleiotropic antithrombotic benefit beyond lipid lowering.

Main Result

Absolute Event Rate: 1.09% vs 2.72%

p-value: p=0.005

Limitations

  • Cannot distinguish whether the reduction of platelet activity is due to the direct effect of statin therapy or an indirect effect of cholesterol lowering.
  • Cannot distinguish whether the reduction of platelet activity is due to the direct effect of statin therapy or an indirect effect of cholesterol lowering

Abstract

INTRODUCTION: Low-density lipoprotein cholesterol (LDL-C) has been reported to increase platelet activation. Reducing the level of LDL-C with statins induces important pleiotropic effects such as platelet inhibition. This association between platelet activity and statin therapy may be clinically important in reducing the risk of ischemic stroke. We investigated the effect of simvastatin therapy on platelet activation markers (platelet CD62P, sP-selectin, and platelet-derived microparticles (PDMPs)) in hyperlipidemic patients after ischemic stroke. MATERIAL AND METHODS: The study group consisted of 21 hyperlipidemic patients after ischemic stroke confirmed by CT, and 20 healthy subjects served as controls. We assessed the CD62P expression on resting and thrombin-activated blood platelets. CD62P and PDMPs were analyzed by the use of monoclonal antibodies anti-CD61 and anti-CD62 on a flow cytometer. The level of sP-selectin in serum was measured by the ELISA (enzyme-linked immunosorbent assay) method. All markers were re-analyzed after 6 months of treatment with simvastatin (20 mg/day). RESULTS: Hyperlipidemic patients presented a significantly higher percentage of CD62+ platelets and higher reactivity to thrombin compared to control subjects. After simvastatin therapy hyperlipidemic patients showed a reduction of the percentage of resting CD62P(+) platelets (p = 0.005) and a reduction of expression and percentage of CD62P(+) platelets after activation by thrombin (median p < 0.05; percentage: p = 0.001). A decrease of sP-selectin levels (p = 0.001) and percentage of PDMPs (p < 0.05) in this group was also observed. CONCLUSIONS: HMG-CoA reductase inhibitor therapy in stroke patients with hyperlipidemia may be useful not only due to the lipid-lowering effect but also because of a significant role in reduction of platelet activation and reactivity.

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Cite This Study

Pawelczyk et al. (2015) conducted an observational in Hyperlipidemia after ischemic stroke (n=41). Simvastatin vs. Baseline was evaluated on Percentage of resting CD62P(+) platelets (p=0.005). Simvastatin therapy (20 mg/day) for 6 months in hyperlipidemic patients after ischemic stroke significantly reduced the percentage of resting CD62P(+) platelets from 2.72% to 1.09%.

synapsesocial.com/papers/6a23c32e4e3df5db62a5e672https://doi.org/10.5114/aoms.2015.49216
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