Key result
A 3-day administration of atorvastatin /d decreased FVII by 6.2% and FXI by 8.6%, which was independently associated with an increase in fibrin clot permeability.
Why the study?
It was unknown whether 3 doses of a statin decrease coagulation factors activity and alter fibrin clot properties in patients with prior VTE and healthy subjects.
Does a 3-day administration of atorvastatin 40 mg/d reduce coagulation factor activity and alter fibrin clot properties in patients with prior VTE and healthy subjects?
Does a 3-day administration of atorvastatin 40 mg/d reduce coagulation factor activity and alter fibrin clot properties in patients with prior VTE and healthy subjects?
A short 3-day course of atorvastatin 40 mg/d is sufficient to reduce FVII and FXI activity and favorably modify fibrin clot properties in both VTE patients and healthy subjects.
Answers are grounded in this paper and cite their sources.
Short-term atorvastatin may alter hemostasis; leaves open whether these changes affect VTE outcomes.
Statins exert antithrombotic effects, which might contribute to reduced risk of venous thromboembolism (VTE). Rosuvastatin 20 mg/d administered for 4 weeks has been reported to decrease coagulation factors (F) VII, FVIII, and FXI in VTE patients. Moreover, in accordance with recent registry data in non-VTE subjects, statins usage was associated with lower FXI. We investigated whether 3 doses of a statin decrease coagulation factors activity and if such changes can alter fibrin clot properties in VTE patients and healthy subjects. We enrolled 28 consecutive first-ever prior VTE patients after 6 months of anticoagulation and 25 healthy controls well-matched for demographics and lipid profiles (aged 44 [interquartile range 34-51] years) in an interventional nonrandomized study. Before and after 3 doses of atorvastatin 40 mg/d, activity of FVII, FVIII, FIX, and FXI was measured, along with fibrin clot properties, including permeability (Ks) and clot lysis using 3 various assays. After a 3-day statin administration, we observed the decrease of FVII (by 6.2%, P = 0.046) and FXI (by 8.6%, P = 0.044), irrespective of low-density lipoprotein cholesterol reduction (by 24%, P < 0.001), whereas other coagulation factors remained unaltered. Reduction of FVII and FXI activity was inversely correlated with Ks alterations (R = -0.292, P = 0.034 and R = -0.335, P = 0.014, respectively). After adjustment for age, studied group, and fibrinogen level, the reduction of FXI was independently associated with an increase of fibrin clot permeability (B = -0.084, P = 0.027). In conclusion, a 3-day 40 mg atorvastatin administration is sufficient to reduce FVII and FXI activity in our pilot study, which is associated with favorable fibrin clot properties modification.
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Stępień et al. (2023) studied Prior Venous Thromboembolism (n=53). Atorvastatin vs. Baseline (before administration) was evaluated on Activity of coagulation factors (FVII, FVIII, FIX, FXI) and fibrin clot properties (p=0.046). A 3-day administration of atorvastatin /d decreased FVII by 6.2% and FXI by 8.6%, which was independently associated with an increase in fibrin clot permeability.
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