Platelet reactivity in patients with venous thrombosis who use rosuvastatin: a randomized controlled clinical trial.
Essentials Statins, especially rosuvastatin, may reduce venous thrombosis risk, but the mechanism is unclear. We performed a randomized trial investigating the effect of rosuvastatin on platelet reactivity. Thromboxane-A2 mediated platelet aggregation was measured before and after rosuvastatin therapy. Rosuvastatin did not inhibit thromboxane-mediated platelet aggregation in venous thrombosis patients.



Background Statins may exert a protective effect against the risk of venous thrombosis (VT), but the mechanism is unclear. Objectives In this open-label, randomized clinical trial (www.clinicaltrials.gov NCT01613794), we aimed to determine the ex vivo effect of rosuvastatin on platelet reactivity in patients with a history of VT. Methods Platelet reactivity, in platelet reaction units (PRUs), was measured at baseline and after 28 days with VerifyNow, which uses arachidonic acid to determine thromboxane-mediated platelet aggregation, in 50 consecutive patients included in our study (25 receiving rosuvastatin and 25 without intervention). Results Forty-seven of 50 (94.0%) consecutively enrolled patients had two valid PRU measurements. The mean PRUs in rosuvastatin users were 609 at baseline and 613 at the end of the study (mean change 5; 95% confidence interval [CI] - 18 to 27). The mean PRUs in non-users were 620 at baseline and 618 at the end of the study (mean change - 2; 95% CI - 15 to 12). The mean difference in PRU change between users and non-users was 6 (95% CI - 20 to 33). After exclusion of patients who used antiplatelet medication, or had thrombocytopenia, similar results were obtained, i.e. no apparent effect of rosuvastatin on PRUs, with a mean difference in PRU change between users and non-users of - 1 (95% CI - 20 to 19). Conclusions Rosuvastatin does not affect platelet reactivity when arachidonic acid is used as an agonist in patients with a history of VT.
Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands.
J S
JS
Biedermann
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.|Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.|Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.
S C
SC
Cannegieter
Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, the Netherlands.|Synapse B.V., Maastricht University, Maastricht, the Netherlands.
M
M
Roest
Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.
F J M
FJ
van der Meer
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.
P H
PH
Reitsma
Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands.
M J H A
MJ
Kruip
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.|Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.|Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.
W M
WM
Lijfering
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D016718:Arachidonic Acid / Q000008:administration & dosage; D001792:Blood Platelets / Q000187:drug effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010979:Platelet Function Tests; D011655:Pulmonary Embolism / Q000188:drug therapy*; D000068718:Rosuvastatin Calcium / Q000008:administration & dosage*; D013928:Thromboxane A2 / Q000494:pharmacology; D020246:Venous Thrombosis / Q000188:drug therapy*; D055815:Young Adult
D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D016718:Arachidonic Acid; D013928:Thromboxane A2; D000068718:Rosuvastatin Calcium
blood platelets; hydroxymethylglutaryl-CoA reductase inhibitors; platelet function test; randomized clinical trial; venous thrombosis