Treatment with simvastatin and low-dose aspirin depresses thrombin generation in patients with coronary heart disease and borderline-high cholesterollevels

Aspirin and statins are beneficial in coronary heart disease across a broad range of cholesterol levels. We assessed the effects of low-dose aspirin ( 75 mg daily) on thrombin generation in patients with coronary heart disease and average blood cholesterol levels. We also investigated whether in pati ents with borderline-high cholesterol level who have been already taking as pirin, additional treatment with simvastatin would affect thrombin generati on. Seven-day treatment with low-dose aspirin decreased thrombin generation ex vivo only in patients with total cholesterol less than or equal to5.2 mmol/ L. In patients with higher cholesterol levels aspirin had no effect. In the se patients. already taking low-dose aspirin. additional three-month simvas tatin treatment resulted in a reduction of thrombin generation. This demons trates that low-dose aspirin depresses thrombin generation only in subjects with desirable blood cholesterol levels, while in others. with borderline- high cholesterol, thrombin formation is being reduced following the additio n of simvastatin.