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

J Diabetes Complications. 2016 Sep-Oct;30(7):1365-70. doi: 10.1016/j.jdiacomp.2016.05.002. Epub 2016 May 10.

Abstract

Background: 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 (>1500pg 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.

Keywords: 11-Dehydrothromboxane B2; CAD; Diabetes; Inflammation; Statin.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aspirin / therapeutic use*
  • Cardiac Catheterization
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / epidemiology
  • Diabetes Mellitus / epidemiology*
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Inflammation / drug therapy*
  • Lipids / blood
  • Lipoproteins / blood
  • Male
  • Middle Aged
  • Thromboxane B2 / analogs & derivatives
  • Thromboxane B2 / urine

Substances

  • Fibrinolytic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids
  • Lipoproteins
  • Thromboxane B2
  • 11-dehydro-thromboxane B2
  • Aspirin