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Erschienen in: Cardiovascular Drugs and Therapy 4/2012

01.08.2012

Impact of Statins on the Coagulation Status of Type 2 Diabetes Patients Evaluated by a Novel Thrombin-Generation Assay

verfasst von: P. Ferroni, D. Della-Morte, A. Pileggi, M. G. Valente, F. Martini, F. La Farina, R. Palmirotta, L. F. Meneghini, T. Rundek, C. Ricordi, F. Guadagni

Erschienen in: Cardiovascular Drugs and Therapy | Ausgabe 4/2012

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Abstract

Purpose

Dyslipidemia is common in type 2 diabetes (T2D) and contributes to cardiovascular disease (CVD) by exacerbating atherosclerosis and hypercoagulability. Statins can stabilize atherosclerotic plaque and reduce prothrombotic status. In the present study we aimed to evaluate the coagulation activity and the effect of statins on procoagulant state of T2D patients using a novel activated protein C (APC)-dependent thrombin-generation assay.

Methods

Procoagulant status (by HemosIL ThromboPath (ThP) assay) and in vivo platelet activation (by plasma soluble (s)CD40L levels) were analyzed in a retrospective, cross-sectional study of 198 patients with long-standing T2D and 198 controls.

Results

Procoagulant status of T2D patients was enhanced when compared to control subjects (p < 0.0001). Similarly, sCD40L levels were increased in T2D (p < 0.0001). When testing ThP as the dependent variable in a multivariate regression model, sCD40L (p < 0.0001) and statin treatment (p = 0.019) were independent predictors of the procoagulant state of T2D patients. Subgroup analysis showed a significant improvement of coagulability in T2D patients on statins (p = 0.012).

Conclusions

The use of a standardized, easy-to-run, and commercially available APC-dependent thrombin-generation assay detected the presence of a procoagulant status in a large series of patients with long-standing T2D and demonstrated a significant impact of statins in the coagulation status of patients with T2D.
Literatur
1.
Zurück zum Zitat Krentz AJ. Lipoprotein abnormalities and their consequences for patients with type 2 diabetes. Diabetes Obes Metab. 2003;5:S19–27.PubMedCrossRef Krentz AJ. Lipoprotein abnormalities and their consequences for patients with type 2 diabetes. Diabetes Obes Metab. 2003;5:S19–27.PubMedCrossRef
2.
Zurück zum Zitat Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010;56:1113–32.PubMedCrossRef Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010;56:1113–32.PubMedCrossRef
3.
Zurück zum Zitat Ferroni P, Basili S, Falco A, Davi G. Platelet activation in type 2 diabetes mellitus. J Thromb Haemost. 2004;2:1282–91.PubMedCrossRef Ferroni P, Basili S, Falco A, Davi G. Platelet activation in type 2 diabetes mellitus. J Thromb Haemost. 2004;2:1282–91.PubMedCrossRef
4.
Zurück zum Zitat Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002;287:2570–81.PubMedCrossRef Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002;287:2570–81.PubMedCrossRef
5.
Zurück zum Zitat Tripodi A, Branchi A, Chantarangkul V, Clerici M, Merati G, Artoni A, et al. Hypercoagulability in patients with type 2 diabetes mellitus detected by a thrombin generation assay. J Thromb Thrombolysis. 2011;31:165–72.PubMedCrossRef Tripodi A, Branchi A, Chantarangkul V, Clerici M, Merati G, Artoni A, et al. Hypercoagulability in patients with type 2 diabetes mellitus detected by a thrombin generation assay. J Thromb Thrombolysis. 2011;31:165–72.PubMedCrossRef
6.
Zurück zum Zitat Palomo I, Alarcon M, Moore-Carrasco R, Argiles JM. Hemostasis alterations in metabolic syndrome (review). Int J Mol Med. 2006;18:969–74.PubMed Palomo I, Alarcon M, Moore-Carrasco R, Argiles JM. Hemostasis alterations in metabolic syndrome (review). Int J Mol Med. 2006;18:969–74.PubMed
7.
Zurück zum Zitat Rubba P. Effects of atorvastatin on the different phases of atherogenesis. Drugs. 2007;67:17–27.PubMedCrossRef Rubba P. Effects of atorvastatin on the different phases of atherogenesis. Drugs. 2007;67:17–27.PubMedCrossRef
8.
Zurück zum Zitat Ludwig S, Shen GX. Statins for diabetic cardiovascular complications. Curr Vasc Pharmacol. 2006;4:245–51.PubMedCrossRef Ludwig S, Shen GX. Statins for diabetic cardiovascular complications. Curr Vasc Pharmacol. 2006;4:245–51.PubMedCrossRef
9.
Zurück zum Zitat Guadagni F, Albertini G, Barbanti P, Volterrani M, Palma E, Lancia A, et al. Foundation and Organization of a high-throughput technology-based Multidisciplinary and InterInstitutional Biobank at the IRCCS San Raffaele Pisana. Biopreserv Biobanking. 2010;7:201–2. Guadagni F, Albertini G, Barbanti P, Volterrani M, Palma E, Lancia A, et al. Foundation and Organization of a high-throughput technology-based Multidisciplinary and InterInstitutional Biobank at the IRCCS San Raffaele Pisana. Biopreserv Biobanking. 2010;7:201–2.
10.
Zurück zum Zitat Guadagni F, Spila A, Nanni U, Somma P, Perrone V, De Angelis F, et al. Automated processing of biological samples. The experience of the InterInstitutional Multidisciplinary Biobank (BioBIM). Biopreserv Biobanking. 2010;7:230–1. Guadagni F, Spila A, Nanni U, Somma P, Perrone V, De Angelis F, et al. Automated processing of biological samples. The experience of the InterInstitutional Multidisciplinary Biobank (BioBIM). Biopreserv Biobanking. 2010;7:230–1.
11.
Zurück zum Zitat Wlodarczyk J, Sullivan D, Smith M. Comparison of benefits and risks of rosuvastatin versus atorvastatin from a meta-analysis of head-to-head randomized controlled trials. Am J Cardiol. 2008;102:1654–62.PubMedCrossRef Wlodarczyk J, Sullivan D, Smith M. Comparison of benefits and risks of rosuvastatin versus atorvastatin from a meta-analysis of head-to-head randomized controlled trials. Am J Cardiol. 2008;102:1654–62.PubMedCrossRef
12.
Zurück zum Zitat Nicholls SJ, Brandrup-Wognsen G, Palmer M, Barter PJ. Meta-analysis of comparative efficacy of increasing dose of Atorvastatin versus Rosuvastatin versus Simvastatin on lowering levels of atherogenic lipids (from VOYAGER). Am J Cardiol. 2010;105:69–76.PubMedCrossRef Nicholls SJ, Brandrup-Wognsen G, Palmer M, Barter PJ. Meta-analysis of comparative efficacy of increasing dose of Atorvastatin versus Rosuvastatin versus Simvastatin on lowering levels of atherogenic lipids (from VOYAGER). Am J Cardiol. 2010;105:69–76.PubMedCrossRef
13.
Zurück zum Zitat Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106:3143–421. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106:3143–421.
14.
Zurück zum Zitat Riondino S, Martini F, La Farina F, Spila A, Guadagni F, Ferroni P. Increased plasma levels of soluble CD40 ligand correlate with platelet activation markers and underline the need for standardized pre-analytical conditions. Clin Biochem. 2010;43:666–70.PubMedCrossRef Riondino S, Martini F, La Farina F, Spila A, Guadagni F, Ferroni P. Increased plasma levels of soluble CD40 ligand correlate with platelet activation markers and underline the need for standardized pre-analytical conditions. Clin Biochem. 2010;43:666–70.PubMedCrossRef
15.
Zurück zum Zitat Toulon P, Smirnov M, Triscott M, Safa O, Biguzzi E, Bouziane K, et al. A new chromogenic assay (HemosIL ThromboPath) is sensitive to major prothrombotic risk factors affecting the protein C pathway. Results of a multicenter study. Thromb Res. 2009;124:137–43.PubMedCrossRef Toulon P, Smirnov M, Triscott M, Safa O, Biguzzi E, Bouziane K, et al. A new chromogenic assay (HemosIL ThromboPath) is sensitive to major prothrombotic risk factors affecting the protein C pathway. Results of a multicenter study. Thromb Res. 2009;124:137–43.PubMedCrossRef
16.
Zurück zum Zitat Adeghate E, Schattner P, Dunn E. An update on the etiology and epidemiology of diabetes mellitus. Ann NY Acad Sci. 2006;1084:1–29.PubMedCrossRef Adeghate E, Schattner P, Dunn E. An update on the etiology and epidemiology of diabetes mellitus. Ann NY Acad Sci. 2006;1084:1–29.PubMedCrossRef
17.
Zurück zum Zitat Ferroni P, La Farina F, Palmirotta R, Martini F, Raparelli V, Nigro C, et al. Predictive value of thrombopath determination in women with pregnancy complications. Clin Chim Acta. 2010;411:37–42.PubMedCrossRef Ferroni P, La Farina F, Palmirotta R, Martini F, Raparelli V, Nigro C, et al. Predictive value of thrombopath determination in women with pregnancy complications. Clin Chim Acta. 2010;411:37–42.PubMedCrossRef
18.
Zurück zum Zitat Tripodi A, Legnani C, Lemma L, Cosmi B, Palareti G, Chantarangkul V, et al. Abnormal Protac-induced coagulation inhibition chromogenic assay results are associated with an increased risk of recurrent venous thromboembolism. J Thromb Thrombolysis. 2010;30:215–9.PubMedCrossRef Tripodi A, Legnani C, Lemma L, Cosmi B, Palareti G, Chantarangkul V, et al. Abnormal Protac-induced coagulation inhibition chromogenic assay results are associated with an increased risk of recurrent venous thromboembolism. J Thromb Thrombolysis. 2010;30:215–9.PubMedCrossRef
19.
Zurück zum Zitat De Stefano V, Finazzi G, Mannucci PM. Inherited thrombophilia: pathogenesis, clinical syndromes, and management. Blood. 1996;87:3531–44.PubMed De Stefano V, Finazzi G, Mannucci PM. Inherited thrombophilia: pathogenesis, clinical syndromes, and management. Blood. 1996;87:3531–44.PubMed
20.
Zurück zum Zitat Krentz A. Type 2 diabetes and atherosclerotic cardiovascular disease: do they share common antecedents? Br J Diabetes Vasc Dis. 2002;2:370–8.CrossRef Krentz A. Type 2 diabetes and atherosclerotic cardiovascular disease: do they share common antecedents? Br J Diabetes Vasc Dis. 2002;2:370–8.CrossRef
21.
Zurück zum Zitat Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352:837–53. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352:837–53.
22.
Zurück zum Zitat Gerstein HC, Miller ME, Byington RP, Goff Jr DC, Bigger JT, Buse JB, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358:2545–59.PubMedCrossRef Gerstein HC, Miller ME, Byington RP, Goff Jr DC, Bigger JT, Buse JB, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358:2545–59.PubMedCrossRef
23.
Zurück zum Zitat Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560–72.PubMedCrossRef Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560–72.PubMedCrossRef
24.
Zurück zum Zitat Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360:129–39.PubMedCrossRef Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360:129–39.PubMedCrossRef
25.
Zurück zum Zitat Colhoun HM, Thomason MJ, Mackness MI, Maton SM, Betteridge DJ, Durrington PN, et al. Design of the Collaborative AtoRvastatin Diabetes Study (CARDS) in patients with type 2 diabetes. Diabet Med. 2002;19:201–11.PubMedCrossRef Colhoun HM, Thomason MJ, Mackness MI, Maton SM, Betteridge DJ, Durrington PN, et al. Design of the Collaborative AtoRvastatin Diabetes Study (CARDS) in patients with type 2 diabetes. Diabet Med. 2002;19:201–11.PubMedCrossRef
26.
Zurück zum Zitat Vasudevan MM, Ballantyne CM. Advances in lipid testing and management in patients with diabetes mellitus. Endocr Pract. 2009;15:641–52.PubMedCrossRef Vasudevan MM, Ballantyne CM. Advances in lipid testing and management in patients with diabetes mellitus. Endocr Pract. 2009;15:641–52.PubMedCrossRef
27.
Zurück zum Zitat Ceriello A, Quatraro A, Marchi E, Barbanti M, Dello Russo P, Lefebvre P, et al. The role of hyperglycaemia-induced alterations of antithrombin III and factor X activation in the thrombin hyperactivity of diabetes mellitus. Diabet Med. 1990;7:343–8.PubMedCrossRef Ceriello A, Quatraro A, Marchi E, Barbanti M, Dello Russo P, Lefebvre P, et al. The role of hyperglycaemia-induced alterations of antithrombin III and factor X activation in the thrombin hyperactivity of diabetes mellitus. Diabet Med. 1990;7:343–8.PubMedCrossRef
28.
Zurück zum Zitat Sauls DL, Banini AE, Boyd LC, Hoffman M. Elevated prothrombin level and shortened clotting times in subjects with type 2 diabetes. J Thromb Haemost. 2007;5:638–9.PubMedCrossRef Sauls DL, Banini AE, Boyd LC, Hoffman M. Elevated prothrombin level and shortened clotting times in subjects with type 2 diabetes. J Thromb Haemost. 2007;5:638–9.PubMedCrossRef
29.
Zurück zum Zitat Santilli F, Davi G, Consoli A, Cipollone F, Mezzetti A, Falco A, et al. Thromboxane-dependent CD40 ligand release in type 2 diabetes mellitus. J Am Coll Cardiol. 2006;47:391–7.PubMedCrossRef Santilli F, Davi G, Consoli A, Cipollone F, Mezzetti A, Falco A, et al. Thromboxane-dependent CD40 ligand release in type 2 diabetes mellitus. J Am Coll Cardiol. 2006;47:391–7.PubMedCrossRef
30.
Zurück zum Zitat Lim HS, Blann AD, Lip GY. Soluble CD40 ligand, soluble P-selectin, interleukin-6, and tissue factor in diabetes mellitus: relationships to cardiovascular disease and risk factor intervention. Circulation. 2004;109:2524–8.PubMedCrossRef Lim HS, Blann AD, Lip GY. Soluble CD40 ligand, soluble P-selectin, interleukin-6, and tissue factor in diabetes mellitus: relationships to cardiovascular disease and risk factor intervention. Circulation. 2004;109:2524–8.PubMedCrossRef
31.
Zurück zum Zitat Varo N, Libby P, Nuzzo R, Italiano J, Doria A, Schönbeck U. Elevated release of sCD40L from platelets of diabetic patients by thrombin, glucose and advanced glycation end products. Diab Vasc Dis Res. 2005;2:81–7.PubMedCrossRef Varo N, Libby P, Nuzzo R, Italiano J, Doria A, Schönbeck U. Elevated release of sCD40L from platelets of diabetic patients by thrombin, glucose and advanced glycation end products. Diab Vasc Dis Res. 2005;2:81–7.PubMedCrossRef
32.
Zurück zum Zitat Neubauer H, Setiadi P, Günesdogan B, Pinto A, Börgel J, Mügge A. Influence of glycaemic control on platelet bound CD40-CD40L system, P-selectin and soluble CD40 ligand in Type 2 diabetes. Diabet Med. 2010;27:384–90.PubMedCrossRef Neubauer H, Setiadi P, Günesdogan B, Pinto A, Börgel J, Mügge A. Influence of glycaemic control on platelet bound CD40-CD40L system, P-selectin and soluble CD40 ligand in Type 2 diabetes. Diabet Med. 2010;27:384–90.PubMedCrossRef
33.
Zurück zum Zitat Bláha V, Andrýs C, Smahelová A, Knízek J, Hyspler R, Solichová D, et al. Effect of atorvastatin on soluble CD14, CD40 Ligand, sE- and sP-selectins and MCP-1 in patients with type 2 diabetes mellitus: relationship to cholesterol turnover. Pharmacol Res. 2006;54:421–8.PubMedCrossRef Bláha V, Andrýs C, Smahelová A, Knízek J, Hyspler R, Solichová D, et al. Effect of atorvastatin on soluble CD14, CD40 Ligand, sE- and sP-selectins and MCP-1 in patients with type 2 diabetes mellitus: relationship to cholesterol turnover. Pharmacol Res. 2006;54:421–8.PubMedCrossRef
34.
Zurück zum Zitat Varo N, Vicent D, Libby P, Nuzzo R, Calle-Pascual AL, Bernal MR, et al. Elevated plasma levels of the atherogenic mediator soluble CD40 ligand in diabetic patients: a novel target of thiazolidinediones. Circulation. 2003;107:2664–9.PubMedCrossRef Varo N, Vicent D, Libby P, Nuzzo R, Calle-Pascual AL, Bernal MR, et al. Elevated plasma levels of the atherogenic mediator soluble CD40 ligand in diabetic patients: a novel target of thiazolidinediones. Circulation. 2003;107:2664–9.PubMedCrossRef
35.
Zurück zum Zitat Santini E, Madec S, Corretti V, Ferrannini E, Solini A. Effect of statins on soluble CD40 ligand in hypercholesterolemic Type 2 diabetic patients. J Endocrinol Invest. 2008;31:660–5.PubMed Santini E, Madec S, Corretti V, Ferrannini E, Solini A. Effect of statins on soluble CD40 ligand in hypercholesterolemic Type 2 diabetic patients. J Endocrinol Invest. 2008;31:660–5.PubMed
36.
Zurück zum Zitat Kinlay S, Schwartz GG, Olsson AG, Rifai N, Sasiela WJ, Szarek M, et al. Effect of atorvastatin on risk of recurrent cardiovascular events after an acute coronary syndrome associated with high soluble CD40 ligand in the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study. Circulation. 2004;110:386–91.PubMedCrossRef Kinlay S, Schwartz GG, Olsson AG, Rifai N, Sasiela WJ, Szarek M, et al. Effect of atorvastatin on risk of recurrent cardiovascular events after an acute coronary syndrome associated with high soluble CD40 ligand in the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study. Circulation. 2004;110:386–91.PubMedCrossRef
37.
Zurück zum Zitat Jaumdally RJ, Lip GY, Varma C, Blann AD. Impact of high-dose atorvastatin on endothelial, platelet, and angiogenic indices: effect of ethnicity, cardiovascular disease, and diabetes. Angiology. 2011;62:571–8.PubMedCrossRef Jaumdally RJ, Lip GY, Varma C, Blann AD. Impact of high-dose atorvastatin on endothelial, platelet, and angiogenic indices: effect of ethnicity, cardiovascular disease, and diabetes. Angiology. 2011;62:571–8.PubMedCrossRef
39.
Zurück zum Zitat Undas A, Brummel-Ziedins KE, Mann KG. Statins and blood coagulation. Arterioscler Thromb Vasc Biol. 2005;25:287–94.PubMedCrossRef Undas A, Brummel-Ziedins KE, Mann KG. Statins and blood coagulation. Arterioscler Thromb Vasc Biol. 2005;25:287–94.PubMedCrossRef
40.
Zurück zum Zitat Arnaboldi L, Corsini A. Do structural differences in statins correlate with clinical efficacy? Curr Opin Lipidol. 2010;21:298–304.PubMedCrossRef Arnaboldi L, Corsini A. Do structural differences in statins correlate with clinical efficacy? Curr Opin Lipidol. 2010;21:298–304.PubMedCrossRef
41.
Zurück zum Zitat Kearney PM, Blackwell L, Collins R, Keech A, Simes J, Peto R, et al. Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet. 2008;371:117–25.PubMedCrossRef Kearney PM, Blackwell L, Collins R, Keech A, Simes J, Peto R, et al. Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet. 2008;371:117–25.PubMedCrossRef
42.
Zurück zum Zitat Avogaro A, Guida P, Giorda C, Mannucci E, Medea G, Comaschi M, et al. The under-use of statin in type 2 diabetic patients attending diabetic clinics in Italy. Nutr Metab Cardiovasc Dis. 2007;17:32–40.PubMedCrossRef Avogaro A, Guida P, Giorda C, Mannucci E, Medea G, Comaschi M, et al. The under-use of statin in type 2 diabetic patients attending diabetic clinics in Italy. Nutr Metab Cardiovasc Dis. 2007;17:32–40.PubMedCrossRef
43.
Zurück zum Zitat Kumar A, Singh V. Atherogenic dyslipidemia and diabetes mellitus: what’s new in the management arena? Vasc Health. Risk Manag. 2010;6:665–9. Kumar A, Singh V. Atherogenic dyslipidemia and diabetes mellitus: what’s new in the management arena? Vasc Health. Risk Manag. 2010;6:665–9.
Metadaten
Titel
Impact of Statins on the Coagulation Status of Type 2 Diabetes Patients Evaluated by a Novel Thrombin-Generation Assay
verfasst von
P. Ferroni
D. Della-Morte
A. Pileggi
M. G. Valente
F. Martini
F. La Farina
R. Palmirotta
L. F. Meneghini
T. Rundek
C. Ricordi
F. Guadagni
Publikationsdatum
01.08.2012
Verlag
Springer US
Erschienen in
Cardiovascular Drugs and Therapy / Ausgabe 4/2012
Print ISSN: 0920-3206
Elektronische ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-012-6388-y

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