Anti-Inflammatory and Anticoagulant Effects of Pravastatin in Patients With Type 2 Diabetes

Anti-Inflammatory and Anticoagulant Effects of Pravastatin in Patients With Type 2 Diabetes Dirkje W. Sommeijer , MD 1 2 , Melvin R. MacGillavry , MD, PHD 2 , Joost C.M. Meijers , PHD 3 , Anton P. Van Zanten , PHD 4 , Pieter H. Reitsma , PHD 1 and Hugo Ten Cate , MD, PHD 1 2 5 1 Laboratory for Experimental Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands 2 Department of Internal Medicine, Slotervaart Hospital, Amsterdam, the Netherlands 3 Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands 4 Department of Clinical Chemistry, Slotervaart Hospital, Amsterdam, the Netherlands 5 Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Academic Hospital and University of Maastricht, Maastricht, the Netherlands Address correspondence and reprint requests to Dirkje W. Sommeijer, MD, Laboratory of Experimental and Internal Medicine, G2–108, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands. E-mail: d.w.sommeijer{at}amc.uva.nl Abstract OBJECTIVE —Type 2 diabetes is associated with increased plasma concentrations of coagulation and inflammation markers. Different studies have shown that treatment with hydroxymethylglutaryl-CoA reductase inhibitors (statins) is associated with antithrombotic and anti-inflammatory effects in addition to a cholesterol-lowering effect. Our objective was to evaluate the effect of pravastatin (40 mg/day) on coagulation and inflammation markers in type 2 diabetic patients. RESEARCH DESIGN AND METHODS —This was an open, randomized, crossover study designed with an 8-week intervention period. The study group was comprised of 50 patients with type 2 diabetes (median HbA 1c 7.1%) and serum total cholesterol of 5–10 mmol/l. We evaluated plasma levels of fibrinogen, F1 + 2, d -dimer, soluble tissue factor (sTF), von Willebrand Factor antigen (vWFag), and C-reactive protein (CRP) in blood samples drawn after fasting on day 1 and after 8 and 16 weeks. RESULTS —Significant reductions of total cholesterol (−22%; P < 0.001), LDL cholesterol (−32%; P < 0.001), and triglycerides (−10%; P < 0.05) were achieved after 8 weeks of treatment with pravastatin. In addition, significant reductions of plasma levels of F1 + 2 (−4.4%; P < 0.05), vWFag (−5.3%; P < 0.05), and sTF (−3.4%; P < 0.05) were observed after treatment with pravastatin. Furthermore, plasma levels of CRP were also significantly reduced (−13%; P < 0.05). Levels of fibr