Effect of high dose statin therapy on platelet function; statins reduce aspirin-resistant platelet aggregation in patients with coronary heart disease.
BACKGROUND
Current evidence supports the preventive role of statins on platelet aggregation in patients with coronary heart disease.


OBJECTIVE
Our aim was to determine the effects of aggressive statin therapy on platelet function in patients with coronary heart disease.


METHODS
A total of 178 consecutive patients (37-68 years old, 35.9% women) with stable coronary artery disease (CAD) was enrolled in the study. Platelet function assays were realized by the Platelet Function Analyzer (PFA)-100 with collagen and epinephrine (Col/Epi) and collagen and ADP (Col/ADP) cartridges. Aspirin resistance was defined as having a closure time (CT) of <186 s with Col/Epi cartridges despite regular aspirin therapy. A statin therapy protocol applied to the patients with aspirin resistance for 3 months.


RESULTS
We determined that 20 (11.2%) of patients had aspirin resistance by the PFA-100. Mean closure time measured with the Col/ADP cartridges was 83 +/- 18 s (53-162 s). Of the patients 12 were not on a statin therapy and eight were taking 10 mg daily atorvastatin. After 3 months of 40 mg daily atorvastatin therapy 13 subjects with aspirin resistance became aspirin sensitive by PFA-100 (P < 0.0001). There was also a significant decrease in total and LDL cholesterol levels and an increase in HDL cholesterol at the third month of statin therapy (P < 0.0001 for all).


CONCLUSIONS
Statin therapy reduced the in vitro aspirin resistance in 65% of the patients after a therapy of 3 months. Further studies are needed to elucidate the mechanism of statins' effects on platelet reactivity.
Tirnaksiz
Ebru
E
Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey.
Pamukcu
Burak
B
Oflaz
Huseyin
H
Nisanci
Yilmaz
Y
D000244:Adenosine Diphosphate / Q000494:pharmacology; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000494:pharmacology; D000069059:Atorvastatin; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003094:Collagen / Q000494:pharmacology; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D048909:Diabetes Complications / Q000097:blood; D004351:Drug Resistance; D004837:Epinephrine / Q000494:pharmacology; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects*; D010979:Platelet Function Tests; D011758:Pyrroles / Q000494:pharmacology* / Q000627:therapeutic use; D012907:Smoking
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000244:Adenosine Diphosphate; D003094:Collagen; D000069059:Atorvastatin; D001241:Aspirin; D004837:Epinephrine