Key result
Atorvastatin treatment for 7 days in patients with unstable angina significantly decreased prothrombin pool concentration to 0.158 rel.units/mL compared to 0.168 rel.units/mL with rosuvastatin.
Why the study?
Statins have multiple pleiotropic effects in acute coronary syndrome, but their influence on the coagulation system remains controversial.
Does atorvastatin compared to rosuvastatin alter plasma coagulability in patients with unstable angina?
Observational (n=50)
No
Does atorvastatin compared to rosuvastatin alter plasma coagulability in patients with unstable angina?
Atorvastatin but not rosuvastatin may alter coagulability markers in unstable angina; leaves open clinical relevance and needs prospective confirmation.
Statins are the integral medications for the management of patients with acute coronary syndrome including unstable angina (UA) with multiple pleiotropic effects. However, the influence of statins on the coagulation system is controversial. Our study aimed to explore the effects of atorvastatin and rosuvastatin in high doses on some coagulation parameters (prothrombin pool (PP) and soluble fibrin-monomer complexes (SFMC) concentration) after a 7-days follow-up period in patients with UA. We recruited 50 patients aged 55 to 70 years with progressive UA. Standard therapy according to ESC guidelines 2020 was recommended for all patients. Before treatment onset, they were divided into 2 groups: group A – 26 patients were prescribed atorvastatin, group R – 24 patients with rosuvastatin treatment. The blood samples to analyze the concentration of PP and SFMC were collected twice – before the treatment onset and 7 days after. We revealed significant decrease in PP concentration (p=0,02) and increase in SFMC concentration (p=0,01) in group A patients while there were no significant changes of investigated parameters (p=0,94, p=0,57 respectively) in group R. Additionally, we have noted significant negative correlation between baseline PP concentration and direction of PP changes (r=-0,803, p<0,001) as well as PP changes direction and SFMC concentration after treatment (r=-0,655, p<0,001). Thus, we may consider that atorvastatin and rosuvastatin are characterized by different influences on coagulation in patients with progressive UA with standard basic treatment. The rebound coagulation system activation after anticoagulant discontinuation is more pronounced in UA patients against a background of atorvastatin treatment in comparison with rosuvastatin.
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Tyravska et al. (2020) conducted an observational in Progressive unstable angina (n=50). Atorvastatin vs. Rosuvastatin 20 mg per day was evaluated on Prothrombin pool (PP) concentration at 7 days (rel.units/mL) (p=0.001). Atorvastatin treatment for 7 days in patients with unstable angina significantly decreased prothrombin pool concentration to 0.158 rel.units/mL compared to 0.168 rel.units/mL with rosuvastatin.
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