Effects of HMG-CoA reductase inhibitor on hemostasis

Clinical trials of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductas e inhibitor (statin) therapy have demonstrated improvement in coronary athe rosclerosis progression and reduction in risk of cardiovascular events. How ever, improvement in cardiovascular end-points is incompletely explained by the baseline or treated LDL cholesterol level. The beneficial effects of s tatins on clinical events may involve nonlipid mechanisms that modify hemos tasis. Local activation of platelets and thrombus formation adjacent to ath eromatous plaques, especially where ruptured or eroded, are now recognized to be of pathophysiological importance in the acute and chronic clinical ex pression of coronary heart disease. Thus, favorable effects of statins on h emostasis may be relevant to decreasing or delaying the progression and cli nical manifestations of atherosclerosis. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.