First Demonstration of dose Dependent Effect of Statin Therapy on Urinary 11-dehydrothromboxane B2 levels in Patients Undergoing Coronary Angiography

Background: Aspirin and statin therapy are primary treatment strategies in patients with cardiovascular disease. Heightened urinary 11-dehydrothromboxane B2(11-dTxB2) levels have been associated with an increased risk of adverse cardiovascular events. The aim of the study was to determine the effect of statin therapy on 11-dTxB2 levels in patients undergoing coronary angiography on 325 mg aspirin. Methods: Urinary 11-dTxB2 was measured in patients prior to coronary angiography with (n 155) and without (n 95) statin therapy. Lipoproteins by vertical density gradient ultracentrifugation technique and thrombin-induced platelet-fibrin clot strength(TIP-FCS), a marker for cardiovascular events by thrombelastography, were also measured. The dose dependent effect of statin therapy was analyzed according to atorvastatin equivalent dose, categorized as: 5-10mg, 20-40mg, 80mg. Results: Baseline demographics and cardiac risk factors were similar between groups. Statins significantly reduced urinary 11-dTxB2 levels in a dose dependent manner (Figure). There was a significant relation between quartiles of 11-dTxB2 and TIPFCS,(p 0.05 for ANOVA). Patients on statin therapy had significantly lower levels of LDL, triglycerides, VLDL, atherox and apo B100 (p 0.005 for all). However, Urinary 11-dTxB2 did not correlate with lipids and lipoproteins measurements. Conclusions: This is the first study to demonstrate the dose dependent response of statin therapy on urinary 11-dTxB2 levels, independent of lipid lowering effects.Clinical outcome studies are required to determine the utility of this novel marker for optimizing statin therapy. TCT-716