Impact of Statins on the Coagulation Status of Type 2 Diabetes Patients Evaluated by a Novel Thrombin-Generation Assay
- 241 Downloads
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.
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.
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).
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.
Key wordsHaemostasis Type 2 Diabetes Dyslipidemia Lipid-Lowering Drugs
This work was partially supported by the Italian Ministry of Health Grant ACC-WP 3/1b and MERIT RBNE08NKH7. The authors wish to thank Francesco De Angelis and Vincenzino Perrone (InterInstitutional Multidisciplinary BioBank, Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS San Raffaele, Rome, Italy), for their excellent technical assistance.
Declaration of Competing Interests
The authors declare that they have no conflict of interest.
- 9.Guadagni F, Albertini G, Barbanti P, Volterrani M, Palma E, Lancia A, et al. Foundation and Organization of a high-throughput technology-based Multidisciplinary and InterInstitutional Biobank at the IRCCS San Raffaele Pisana. Biopreserv Biobanking. 2010;7:201–2.Google Scholar
- 10.Guadagni F, Spila A, Nanni U, Somma P, Perrone V, De Angelis F, et al. Automated processing of biological samples. The experience of the InterInstitutional Multidisciplinary Biobank (BioBIM). Biopreserv Biobanking. 2010;7:230–1.Google Scholar
- 13.Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106:3143–421.Google Scholar
- 21.Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352:837–53.Google Scholar
- 36.Kinlay S, Schwartz GG, Olsson AG, Rifai N, Sasiela WJ, Szarek M, et al. Effect of atorvastatin on risk of recurrent cardiovascular events after an acute coronary syndrome associated with high soluble CD40 ligand in the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study. Circulation. 2004;110:386–91.PubMedCrossRefGoogle Scholar
- 43.Kumar A, Singh V. Atherogenic dyslipidemia and diabetes mellitus: what’s new in the management arena? Vasc Health. Risk Manag. 2010;6:665–9.Google Scholar