The influence of statin therapy on platelet activity markers in hyperlipidemic patients after ischemic stroke

Malgorzata Pawelczyk, Henryk Chmielewski, Beata Kaczorowska, Monika Przybyła, Zbigniew Baj, Malgorzata Pawelczyk, Henryk Chmielewski, Beata Kaczorowska, Monika Przybyła, Zbigniew Baj

Abstract

Introduction: Low-density lipoprotein cholesterol (LDL-C) has been reported to increase platelet activation. Reducing the level of LDL-C with statins induces important pleiotropic effects such as platelet inhibition. This association between platelet activity and statin therapy may be clinically important in reducing the risk of ischemic stroke. We investigated the effect of simvastatin therapy on platelet activation markers (platelet CD62P, sP-selectin, and platelet-derived microparticles (PDMPs)) in hyperlipidemic patients after ischemic stroke.

Material and methods: The study group consisted of 21 hyperlipidemic patients after ischemic stroke confirmed by CT, and 20 healthy subjects served as controls. We assessed the CD62P expression on resting and thrombin-activated blood platelets. CD62P and PDMPs were analyzed by the use of monoclonal antibodies anti-CD61 and anti-CD62 on a flow cytometer. The level of sP-selectin in serum was measured by the ELISA (enzyme-linked immunosorbent assay) method. All markers were re-analyzed after 6 months of treatment with simvastatin (20 mg/day).

Results: Hyperlipidemic patients presented a significantly higher percentage of CD62+ platelets and higher reactivity to thrombin compared to control subjects. After simvastatin therapy hyperlipidemic patients showed a reduction of the percentage of resting CD62P(+) platelets (p = 0.005) and a reduction of expression and percentage of CD62P(+) platelets after activation by thrombin (median p < 0.05; percentage: p = 0.001). A decrease of sP-selectin levels (p = 0.001) and percentage of PDMPs (p < 0.05) in this group was also observed.

Conclusions: HMG-CoA reductase inhibitor therapy in stroke patients with hyperlipidemia may be useful not only due to the lipid-lowering effect but also because of a significant role in reduction of platelet activation and reactivity.

Keywords: CD62P; HMG-CoA reductase inhibitor; hyperlipidemia; ischemic stroke; platelet-derived microparticles; platelets; sP-selectin.

Figures

Figure 1
Figure 1
Percentage and expression of resting (A, B) and thrombin-activated (C, D) CD62P(+) platelets in hyperlipidemic stroke patients at baseline and after simvastatin therapy HL – hyperlipidemic group, CS – control subjects.
Figure 2
Figure 2
Soluble P-selectin (sP-selectin) concentration at baseline and after treatment with simvastatin in study subjects HL – hyperlipidemic group, CS – control subjects.
Figure 3
Figure 3
Percentage of platelet-derived microparticles (PDMPs) at baseline and after treatment with simvastatin in study subjects HL – hyperlipidemic group, CS – control subjects.

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