Statin therapy and levels of hemostatic factors in a healthy population: The Multi-Ethnic study of atherosclerosis

N. B. Adams, P. L. Lutsey, A. R. Folsom, D. H. Herrington, C. T. Sibley, N. A. Zakai, S. Ades, G. L. Burke, M. Cushman

Research output: Contribution to journalArticle

41 Scopus citations

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. Aim: 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.

Original languageEnglish (US)
Pages (from-to)1078-1084
Number of pages7
JournalJournal of Thrombosis and Haemostasis
Volume11
Issue number6
DOIs
StatePublished - Jun 2013

Keywords

  • Blood coagulation
  • Fibrinolysis
  • Inflammation
  • Risk factor
  • Statins
  • Thrombosis

ASJC Scopus subject areas

  • Hematology

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    Adams, N. B., Lutsey, P. L., Folsom, A. R., Herrington, D. H., Sibley, C. T., Zakai, N. A., Ades, S., Burke, G. L., & Cushman, M. (2013). Statin therapy and levels of hemostatic factors in a healthy population: The Multi-Ethnic study of atherosclerosis. Journal of Thrombosis and Haemostasis, 11(6), 1078-1084. https://doi.org/10.1111/jth.12223