title: Impact of statins on the coagulation status of type 2 diabetes patients evaluated by a novel thrombin-generation assay.
abstract: OBJECTIVE
  Dyslipidemia is common in type 2 diabetes (T2D) and contributes to cardiovascular disease (CVD) by exacerbating atherosclerosis and hypercoagulability. Statins can stabilize atherosclerotic plaque and reduce prothrombotic status. In the present study we aimed to evaluate the coagulation activity and the effect of statins on procoagulant state of T2D patients using a novel activated protein C (APC)-dependent thrombin-generation assay.
  
  
  METHODS
  Procoagulant status (by HemosIL ThromboPath (ThP) assay) and in vivo platelet activation (by plasma soluble (s)CD40L levels) were analyzed in a retrospective, cross-sectional study of 198 patients with long-standing T2D and 198 controls.
  
  
  RESULTS
  Procoagulant status of T2D patients was enhanced when compared to control subjects (p < 0.0001). Similarly, sCD40L levels were increased in T2D (p < 0.0001). When testing ThP as the dependent variable in a multivariate regression model, sCD40L (p < 0.0001) and statin treatment (p = 0.019) were independent predictors of the procoagulant state of T2D patients. Subgroup analysis showed a significant improvement of coagulability in T2D patients on statins (p = 0.012).
  
  
  CONCLUSIONS
  The use of a standardized, easy-to-run, and commercially available APC-dependent thrombin-generation assay detected the presence of a procoagulant status in a large series of patients with long-standing T2D and demonstrated a significant impact of statins in the coagulation status of patients with T2D.
authors.affiliation: Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS San Raffaele Pisana, Rome, Italy. patrizia.ferroni@sanraffaele.it
authors.forename: P
authors.initials: P
authors.lastname: Ferroni
authors.forename: D
authors.initials: D
authors.lastname: Della-Morte
authors.forename: A
authors.initials: A
authors.lastname: Pileggi
authors.forename: M G
authors.initials: MG
authors.lastname: Valente
authors.forename: F
authors.initials: F
authors.lastname: Martini
authors.forename: F
authors.initials: F
authors.lastname: La Farina
authors.forename: R
authors.initials: R
authors.lastname: Palmirotta
authors.forename: L F
authors.initials: LF
authors.lastname: Meneghini
authors.forename: T
authors.initials: T
authors.lastname: Rundek
authors.forename: C
authors.initials: C
authors.lastname: Ricordi
authors.forename: F
authors.initials: F
authors.lastname: Guadagni
mesh_terms: D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects*; D023201:CD40 Ligand / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D015539:Platelet Activation / Q000187:drug effects; D011486:Protein C / Q000378:metabolism; D012189:Retrospective Studies; D013917:Thrombin / Q000737:chemistry*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011486:Protein C; D023201:CD40 Ligand; D013917:Thrombin