title: Statin therapy and levels of hemostatic factors in a healthy population: the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  HMG-CoA reductase inhibitors (statins) reduce the risk of venous thromboembolism (VTE) in healthy people. Statins reduce levels of inflammation biomarkers; however, the mechanism for the reduction in VTE risk is unknown.
  
  
  OBJECTIVE
  In a large cohort of healthy people, we studied associations of statin use with plasma hemostatic factors related to VTE risk.
  
  
  METHODS
  Cross-sectional analyses were performed in the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort study of 6814 healthy men and women aged 45-84 years, free of clinical cardiovascular disease at baseline; 1001 were using statins at baseline. Twenty-three warfarin users were excluded. Age, race and sex-adjusted mean hemostatic factor levels were compared between statin users and non-users, and multivariable linear regression models were used to assess associations of statin use with hemostatic factors, adjusted for age, race/ethnicity, education, income, aspirin use, hormone replacement therapy (in women), and major cardiovascular risk factors.
  
  
  RESULTS
  Participants using statins had lower adjusted levels of D-dimer (- 9%), C-reactive protein (- 21%) and factor VIII (- 3%) than non-users (P < 0.05). Homocysteine and von Willebrand factor levels were non-significantly lower with statin use. Higher fibrinogen (2%) and plasminogen activator inhibitor-1 (22%) levels were observed among statin users than among non-users (P < 0.05). Further adjustment for LDL and triglyceride levels did not attenuate the observed differences in these factors with statin use.
  
  
  CONCLUSIONS
  Findings of lower D-dimer, FVIII and C-reactive protein levels with statin use suggest hypotheses for mechanisms whereby statins might lower VTE risk. A prospective study or clinical trial linking these biochemical differences to VTE outcomes in statin users and non-users is warranted.
authors.affiliation: Department of Medicine, University of Vermont, Burlington, VT 05446, USA.
authors.forename: N B
authors.initials: NB
authors.lastname: Adams
authors.forename: P L
authors.initials: PL
authors.lastname: Lutsey
authors.forename: A R
authors.initials: AR
authors.lastname: Folsom
authors.forename: D H
authors.initials: DH
authors.lastname: Herrington
authors.forename: C T
authors.initials: CT
authors.lastname: Sibley
authors.forename: N A
authors.initials: NA
authors.lastname: Zakai
authors.forename: S
authors.initials: S
authors.lastname: Ades
authors.forename: G L
authors.initials: GL
authors.lastname: Burke
authors.forename: M
authors.initials: M
authors.lastname: Cushman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D015415:Biomarkers / Q000378:metabolism; D001777:Blood Coagulation; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D015331:Cohort Studies; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005342:Fibrinolysis; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013917:Thrombin / Q000378:metabolism; D054556:Venous Thromboembolism / Q000097:blood* / Q000517:prevention & control
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C036309:fibrin fragment D; C078147:F8 protein, human; D005169:Factor VIII; D002097:C-Reactive Protein; D013917:Thrombin
keywords: blood coagulation; fibrinolysis; inflammation; risk factor; statins; thrombosis
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