Abstract 15997: First Report of a Dose Dependent Effect of Statin Therapy on Urinary 11-dehydrothromboxane B&rtf-inf-start;2 &rtf-inf-end;Levels: A New Marker for Personalizing Statin Therapy

Abstract

BACKGROUND: Aspirin (ASA) and statins are primary treatment strategies for patients with cardiovascular disease. It has been proposed that urinary 11-dehydrothromboxane B₂ (11-DTxB₂) is a marker of systemic inflammation and high levels have been associated increased cardiovascular event rates. Our aim was to determine the effect of statin therapy on 11-DTxB₂ levels in patients undergoing elective coronary angiography on ASA (325 mg daily).

METHODS: Urinary 11-DTxB₂ was measured by ELISA just prior to angiography in patients treated with (n=155) and without (n=95) statin therapy. Lipid profile was determined by vertical density gradient ultracentrifugation and platelet function [thrombin-induced platelet-fibrin clot strength (TIP-FCS), a marker of adverse cardiovascular event risk] by thrombelastography. The dose dependent effect of statin therapy was analyzed using an algorithm converting doses of various statins to an atorvastatin equivalent doses of 5-10 mg, 20-40 mg, and 80 mg.

RESULTS: Baseline demographics and cardiac risk factors were similar between groups. Statin therapy significantly and dose-dependently reduced urinary 11-DTxB₂ levels (Figure). A significant relation between quartiles of 11-DTxB₂ and TIP-FCS was also observed (p<0.05 for ANOVA). Patients on statin therapy had significantly lower levels of LDL (83±27 vs. 114±34, p<0.001), triglycerides (112±62 vs. 139±45, p=0.004), VLDL (20±8 vs. 26±16, p<0.001), atherox (0.32±0.37 vs. 0.58±0.56, p<0.001), and apo B100 (76±18 vs. 94±23, p<0.001). However, Urinary 11-DTxB₂ did not correlate with lipid and lipoprotein measurements.

CONCLUSION: This is the first demstration that statin therapy reduced thromboxane A₂ production in a dose-dependent manner that was independent of a lipid lowering effect. We propose urinary 11-DTxB₂ as a newmarker for future trials designed to personalize statin therapy in CAD patients.