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

Thromb Haemost. 2016 Mar;115(3):520-32. doi: 10.1160/TH15-08-0620. Epub 2015 Dec 3.

Abstract

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-analysis 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), atorvastatin (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.

Keywords: atherosclerosis; cardiovascular diseases; statins; thrombosis; von Willebrand Antigen.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Antigens / blood
  • Atherosclerosis / blood
  • Atherosclerosis / drug therapy
  • Atorvastatin / therapeutic use
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / drug therapy
  • Fatty Acids, Monounsaturated / therapeutic use
  • Female
  • Fluvastatin
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Indoles / therapeutic use
  • Male
  • Middle Aged
  • Pravastatin / therapeutic use
  • Randomized Controlled Trials as Topic
  • Regression Analysis
  • Risk Assessment
  • Rosuvastatin Calcium / therapeutic use
  • Simvastatin / therapeutic use
  • Thrombosis / blood
  • Thrombosis / drug therapy
  • Young Adult
  • von Willebrand Factor / chemistry*

Substances

  • Antigens
  • Fatty Acids, Monounsaturated
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Indoles
  • von Willebrand Factor
  • Fluvastatin
  • Rosuvastatin Calcium
  • Atorvastatin
  • Simvastatin
  • Pravastatin