Statins in prevention of thromboembolic events : from seminal studies to recent advances

2022
journal article
review article
20
dc.abstract.enStatins, 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors, reduce the rate of cardiovascular events in primary and secondary prevention, and represent a cornerstone in the management of atherosclerotic vascular disease. Statins were also shown to be effective in lowering the risk of venous thromboembolism (VTE) in its primary and secondary prevention, but their use in VTE prophylaxis is still not approved and recommended in current guidelines. Several antithrombotic mechanisms of these cholesterol-lowering agents, largely independent of the magnitude of low-density lipoprotein cholesterol reduction, were demonstrated in a broad spectrum of experimental in vitro and in vivo models. However, these studies yielded inconsistent results, such as substantial differences related to the use of specific statins, their dose or final concentration, and even the clinical setting (patients with cardiovascular disease or VTE vs healthy subjects). Anticoagulant properties of statins, reported for the first time 25 years ago, involve downregulation of tissue factor expression with a subsequent decreased thrombin generation and inhibition of thrombin-mediated reactions, including factor V and factor XIII activation, and enhanced endothelial thrombomodulin expression resulting in increased protein C activation. Enhanced fibrinolysis was also reported partly as a result of reduced activity of fibrinolysis inhibitors such as plasminogen activator inhibitor-1 (PAI-1) and thrombin-activatable fibrinolysis inhibitor. This review summarizes the findings of the studies from the 1990s until the most recent reports to update our knowledge on the impact of statins on blood coagulation and its potential clinical relevance.
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.cm.date2022-04-08T06:26:40Z
dc.cm.id107464pl
dc.cm.idOmegaUJCMf781f73b8def468782d2a618b240e194pl
dc.contributor.authorUndas, Anetta - 133708 pl
dc.date.accession2022-03-05pl
dc.date.accessioned2022-04-08T06:26:40Z
dc.date.available2022-04-08T06:26:40Z
dc.date.issued2022pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number2pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume132pl
dc.identifier.articleid16208pl
dc.identifier.doi10.20452/pamw.16208pl
dc.identifier.eissn1897-9483pl
dc.identifier.issn0032-3772pl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/290513
dc.identifier.weblinkhttps://www.mp.pl/paim/issue/article/16208/pl
dc.languageengpl
dc.language.containerpolpl
dc.pbn.affiliationDziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa
dc.rights.licenceCC-BY-NC-SA
dc.rights.urihttps://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl
dc.share.typeOtwarte czasopismo
dc.subject.enblood coagulation
dc.subject.enstatins
dc.subject.enthrombin generation
dc.subject.enthromboembolism
dc.subject.entissue factor
dc.subtypeReviewArticlepl
dc.titleStatins in prevention of thromboembolic events : from seminal studies to recent advancespl
dc.title.journalPolskie Archiwum Medycyny Wewnetrznejpl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.en
Statins, 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors, reduce the rate of cardiovascular events in primary and secondary prevention, and represent a cornerstone in the management of atherosclerotic vascular disease. Statins were also shown to be effective in lowering the risk of venous thromboembolism (VTE) in its primary and secondary prevention, but their use in VTE prophylaxis is still not approved and recommended in current guidelines. Several antithrombotic mechanisms of these cholesterol-lowering agents, largely independent of the magnitude of low-density lipoprotein cholesterol reduction, were demonstrated in a broad spectrum of experimental in vitro and in vivo models. However, these studies yielded inconsistent results, such as substantial differences related to the use of specific statins, their dose or final concentration, and even the clinical setting (patients with cardiovascular disease or VTE vs healthy subjects). Anticoagulant properties of statins, reported for the first time 25 years ago, involve downregulation of tissue factor expression with a subsequent decreased thrombin generation and inhibition of thrombin-mediated reactions, including factor V and factor XIII activation, and enhanced endothelial thrombomodulin expression resulting in increased protein C activation. Enhanced fibrinolysis was also reported partly as a result of reduced activity of fibrinolysis inhibitors such as plasminogen activator inhibitor-1 (PAI-1) and thrombin-activatable fibrinolysis inhibitor. This review summarizes the findings of the studies from the 1990s until the most recent reports to update our knowledge on the impact of statins on blood coagulation and its potential clinical relevance.
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.cm.date
2022-04-08T06:26:40Z
dc.cm.idpl
107464
dc.cm.idOmegapl
UJCMf781f73b8def468782d2a618b240e194
dc.contributor.authorpl
Undas, Anetta - 133708
dc.date.accessionpl
2022-03-05
dc.date.accessioned
2022-04-08T06:26:40Z
dc.date.available
2022-04-08T06:26:40Z
dc.date.issuedpl
2022
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
2
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
132
dc.identifier.articleidpl
16208
dc.identifier.doipl
10.20452/pamw.16208
dc.identifier.eissnpl
1897-9483
dc.identifier.issnpl
0032-3772
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/290513
dc.identifier.weblinkpl
https://www.mp.pl/paim/issue/article/16208/
dc.languagepl
eng
dc.language.containerpl
pol
dc.pbn.affiliation
Dziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne
dc.rights
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-SA
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl
dc.share.type
Otwarte czasopismo
dc.subject.en
blood coagulation
dc.subject.en
statins
dc.subject.en
thrombin generation
dc.subject.en
thromboembolism
dc.subject.en
tissue factor
dc.subtypepl
ReviewArticle
dc.titlepl
Statins in prevention of thromboembolic events : from seminal studies to recent advances
dc.title.journalpl
Polskie Archiwum Medycyny Wewnetrznej
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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