The impact of statin therapy on plasma levels of von Willebrand factor antigen: Systematic review and meta-analysis of Randomised placebo-controlled trials

Amirhossein Sahebkar, C. Serban, S. Ursoniu, D.P. Mikhailidis, A. Undas, G.Y.H. Lip, V. Bittner, K.K. Ray, Gerald F. Watts, G. Kees Hovingh, J. Rysz, J.J.P. Kastelein, M. Banach

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    Abstract

    © Schattauer 2016. Increased plasma levels of von Willebrand factor antigen (vWF:Ag) are associated with high risk of coronary artery disease. The effect of sta­tin therapy on vWF:Ag levels remains uncertain. Therefore the aim of this meta-analysis was to evaluate the effect of statin therapy on vWF:Ag Levels. A systematic multiple-database search was carried out to identify randomized controlled trials (RCTs) that investigated the effect of statins on plasma vWF:Ag levels. Random-effect meta-analy-sis of 21 treatment arms revealed a significant decrease in plasma vWF:Ag levels following statin therapy (SMD: -0.54, 95 %CI: -0.87, -0.21, p=0.001). In subgroup analyses, the greatest effect was ob­served with simvastatin (SMD: -1.54, 95 %>CI: -2.92, -0.17, p=0.028) and pravastatin (SMD: -0.61, 95 %>CI: -1.18, -0.04, p=0.035), but not with fluvastatin (SMD: -0.34, 95 %>CI: -0.69, 0.02, p=0.065), atorvas-tatin (SMD: -0.23, 95 %>CI: -0.57, 0.11, p=0.179) and rosuvastatin (SMD: -0.20, 95 %% CI: -0.71, 0.30, p=0.431). The lowering effect of statins on plasma vWF:Ag levels was greater in the subset of studies lasting > 12 weeks (SMD: -0.70, 95 %>CI: -1.19, -0.22, p=0.005) com­pared with that of studies lasting <12 weeks (SMD: -0.34, 95 %>CI: -0.67, 0.003, p=0.052). Finally, low-intensity statin therapy was not associated with a significant reduction in vWF:Ag levels (SMD: -0.28, 95%CI: -0.82, 0.27, p=0.320), but a significant effect was observed in high-intensity statin trials (SMD: -0.66, 95 %>CI: -1.07, -0.24, p=0.002). This meta-analysis of available RCTs demonstrates a signifi­cant reduction in plasma vWF:Ag levels following statin therapy.
    Original languageEnglish
    Pages (from-to)520-532
    Number of pages13
    JournalThrombosis and Haemostasis
    Volume115
    Issue number3
    DOIs
    Publication statusPublished - 2016

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