Statin therapy and inflammation in patients with diabetes treated with high dose aspirin

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• 作者：Rahul Chaudhary^a ; Kevin P. Bliden^b ; Jalaj Garg^c ; Nafees Mohammed^a ; Udaya Tantry^b ; Denny Mathew^a ; Peter P. Toth^d ; Christopher Franzese^b ; Martin Gesheff^b ; Shachi Pandya^b ; Paul Gurbel^b ; ^{Paul.Gurbel@inova.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Statin ; Diabetes ; CAD ; Inflammation ; 11-Dehydrothromboxane B2
• 刊名：Journal of Diabetes and its Complications
• 出版年：2016
• 出版时间：September-October 2016
• 年：2016
• 卷：30
• 期：7
• 页码：1365-1370
• 全文大小：423 K

文摘

Statin and aspirin form the therapeutic cornerstone in patients with coronary artery disease (CAD) and diabetes. Little is known about relationship of statins with blood thrombogenicity and inflammation in these patients.

Methods

Two hundred nine consecutive patients with diabetes and suspected CAD undergoing elective cardiac catheterization were divided in groups based on statin treatment in the Multi-Analyte, Thrombogenic, and Genetic Markers Atherosclerosis study. Urinary 11-dehydrothromboxane B2 (11-dh-TxB2), lipid profile and oxLDL/β2GPI were measured by AspirinWorks™ ELISA assay, vertical density gradient ultracentrifugation and immunoassay respectively. Thrombelastography, and ADP- and collagen-induced light transmittance aggregometry assessed thrombogenicity. CAD was classified as none/minor [< 20% diameter stenosis (DS)], moderate (20–75% DS), or severe (> 75% DS).

Results

Severe, moderate, and no CAD was observed in 66, 19, and 15% of patients respectively. Patients on statins had significantly lower 11-dh-TxB2, collagen-induced aggregation, total cholesterol, total LDL, LDL3, oxidized-LDL, Apo B100, and ApoB100/A1 ratio (p < 0.01 for all). Statin therapy demonstrated a lower proportion of patients with high urinary 11-dh-TxB2 (> 1500 pg 11-dh-TxB2/mg creatinine) (25 vs. 57%, p = 0.01).

Conclusion

Statins along with aspirin, confers additional anti-inflammatory and antithrombotic effect in diabetics with CAD. Urinary 11-dh-TxB2 may be a useful biomarker for personalizing statin therapy.