Abstract 15739: Statin Therapy and Inflammation in Patients With Diabetes Treated With High Dose Aspirin
Background: The role of aspirin and statins in high risk patients with coronary artery disease (CAD) and diabetes mellitus (DM) is well established. We aim to evaluate the relationship of lipid lowering therapy with 1) in-vivo thromboxane (Tx) generation, a marker of inflammation, blood thrombogenicity, and cholesterol levels in DM patients with suspected coronary artery disease on high dose aspirin therapy.
Methods: Patients with DM and suspected CAD on statins (n=167) were compared to DM not on statins (n=42) in the Multi-Analyte, Thrombogenic, and Genetic Markers of Atherosclerosis study. Urinary 11-dehydrothromboxane B2 (11-dh-TxB2) was measured using AspirinWorksTM ELISA assay. Lipid profile was determined by vertical density gradient ultracentrifugation and AtherOx testing was performed by immunoassay. Thrombogenicity was assessed by thrombelastography, and ADP and collagen-induced light transmittance aggregometry. Blood and urine samples were collected immediately prior to elective coronary angiography.CAD was defined as none/minor (<20% diameter stenosis (DS)), moderate (20%-75% DS), and significant (75% DS) of any major coronary vessel.
Results: Sixty-six percent, 19%, and 15% of patients had severe, moderate, and no CAD, respectively. Statin therapy was associated with lower 11-dh-TxB2 (figure), collagen- induced aggregation, total cholesterol, total LDL, LDL3, oxidized LDL, Apo B 100, and ApoB100/A1 ratio (p more than 0.01 for all). Statin therapy was associated with a lower proportion of high urinary 11-dh-TxB2 (>1500 pg 11-dh-TxB2/ mg creatinine) compared to patients not on statin therapy (25% vs. 57%, p=0.01).
Conclusions: Statin therapy appears to confer a further anti-inflammatory effect to high dose aspirin in patients with diabetes and CAD; measurement of urinary 11-dh-TxB2 may be a useful tool in personalizing statin therapy to optimally attenuate inflammation in DM.
Author Disclosures: K. Bliden: None. R. Rafeedheen: None. U. Tantry: None. P.P. Toth: None. C. Franzese: None. M. Gesheff: None. S. Pandya: None. P.A. Gurbel: Research Grant; Modest; Accumetrics. Research Grant; Significant; National Institutes of Health, Daiichi Sankyo/Lilly, CSL, AstraZeneca, , Harvard Clinical Research Institute, Bayer, Haemonetics and Duke Clinical Research Institute, Sinnowa, Coramed, Multiplate. Speakers Bureau; Significant; AstraZeneca, Daiichi Sankyo/ Lilly, Merck. Honoraria; Modest; Boehringer Ingleheim. Honoraria; Significant; AstraZeneca, Daiichi Sankyo/ Lilly, Merck. Consultant/Advisory Board; Significant; AstraZeneca, Daiichi Sankyo/ Lilly, Merck, Accumetrics,.
- © 2014 by American Heart Association, Inc.