Decrease of hemostatic cardiovascular risk factors by aggressive vs. conventional atorvastatin treatment in patients with Type 2 diabetes mellitus.
BACKGROUND
Patients with Type 2 diabetes mellitus have increased levels of hemostatic risk variables for cardiovascular disease, such as fibrinogen, von Willebrand factor (VWF), factor (F)VIIa, d-dimer and plasminogen activator inhibitor-1 (PAI-1).


OBJECTIVE
To evaluate the effect of aggressive vs. standard dose atorvastatin on hemostatic cardiovascular risk factors in patients with Type 2 diabetes mellitus.


METHODS
The effect of 30 weeks of treatment with atorvastatin 10 and 80 mg on hemostatic cardiovascular risk factors was assessed in a randomized double-blind placebo-controlled trial on 217 patients with Type 2 diabetes mellitus and dyslipidemia.


CONCLUSIONS
Atorvastatin 10 and 80 mg dose-dependently reduced d-dimer (7.4% and 8.5%, respectively, P for trend = 0.004) and PAI-1 antigen levels (9.0% and 18%, respectively, P for trend = 0.021). Levels of fibrinogen, VWF, tissue-type plasminogen activator and FVIIa were not influenced by atorvastatin. In conclusion, in patients with Type 2 diabetes mellitus, atorvastatin dose-dependently improved the levels of the hemostatic risk variables d-dimer and PAI-1.
Van De Ree
M A
MA
Department of General Internal Medicine, Leiden University Medical Center and Gaubius Laboratory TNO-PG, Leiden, the Netherlands.
De Maat
M P M
MP
Kluft
C
C
Meinders
A E
AE
Princen
H M G
HM
Huisman
M V
MV
D000368:Aged; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D015944:Factor VIIIa / Q000096:biosynthesis; D005260:Female; D005340:Fibrinogen / Q000096:biosynthesis; D006490:Hemostatics / Q000627:therapeutic use; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011758:Pyrroles / Q000627:therapeutic use*; D012307:Risk Factors; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000097:blood; D014841:von Willebrand Factor / Q000096:biosynthesis
D006490:Hemostatics; D006538:Heptanoic Acids; D010919:Placebos; D011758:Pyrroles; D014841:von Willebrand Factor; D015944:Factor VIIIa; D005340:Fibrinogen; D000069059:Atorvastatin; D010959:Tissue Plasminogen Activator