Fluvastatin decreases soluble thrombomodulin in cardiac transplant recipients

We conducted a randomized, placebo controlled, double-blind, cross-over stu dy, to assess the effects of a I-week fluvastatin therapy on plasma markers of endothelial activation or injury in 20 transplanted heart recipients. T he levels of thrombomodulin and von Willebrand factor antigen were higher a t baseline in cardiac transplant recipients than in age and sex-matched hea lthy controls. Plasma total cholesterol showed a 21% reduction on fluvastat in therapy (p = 0.0001). Fluvastatin treatment had no significant effect on creatininemia, plasma cyclosporine, PAI-I antigen, PAI-I activity, tPA ant igen, and Von Willebrand factor. However, fluvastatin produced a significan t decrease of plasma thrombomodulin (66.7 ng/ml on placebo versus 58.8 ng/m l on fluvastatin. p <0.001), suggesting a rapid improvement of endothelial injury in these patients.