Similar effects of atorvastatin, simvastatin and pravastatin on thrombogenic and inflammatory parameters in patients with hypercholesterolemia

Background: Previous studies have suggested that statins exert beneficial e ffects beyond their favorable lipid lowering effect. Particularly, the modi fication of thrombus formation and degradation, alteration in inflammatory response, plaque stabilization and improved endothelial function are though t to be responsible for additional reduction of morbidity and mortality due to cardiovascular events. To date, however, it is still unclear whether th ese effects are elicited by all statins. Methods and Results: We set out to compare in a controlled, randomized, double-blind study design the effects of almost equieffective cholesterol lowering doses of three chemically and pharmacokinetically different statins (atorvastatin, simvastatin, pravasta tin) on hemostatic and inflammatory markers in 99 hypercholesterblemic pati ents. At entry and 3 months after onset of statin therapy plasma cholestero l and von Willebrand factor antigen (vWf-Ag), fibrinogen, d-dimer, prothrom bin fragment 1+2 (F1.2) and C-reactive protein (CRP) were measured. The eff ect on plasma values of F1.2, vWf-Ag, d-dimer and CRP was not significantly different between the three treatment groups. The effect of simvastatin on fibrinogen (p = 0.005) was more pronounced than the effects of atorvastati n (p = 0.48 n.s.) and pravastatin (p = 0.15 n.s.). Plasma levels of F1.2 an d vWf-Ag (when data of all statins were pooled) were significantly reduced by 7% and 10% versus baseline, respectively. No significant reduction was o bserved for d-dimer (p = 0.26) and CRP (p = 0.5). Total plasma cholesterol levels decreased significantly (p <0.0001 in ail groups) between 22% and 29 % compared to baseline. Conclusion: The present study shows similar shortte rm (3-months) effects of atorvastatin, simvastatin and pravastatin on selec ted hemostatic and inflammatory parameters in plasma in patients with hyper cholesterolemia. Thus, chemical and pharmacological differences between sta tins appear to exert no major influence on these parameters.