Do statins influence platelet reactivity on acetylsalicylic acid therapy in patients with type 2 diabetes?

Abstract

BACKGROUND: Type 2 diabetes (T2DM) patients are at increased risk of cardiovascular
events despite long-term acetylsalicylic acid (ASA) therapy. This study was performed to
establish the prevalence of high platelet reactivity (HPR) on ASA in T2DM and to identify its
predictors.

METHODS: The study included 185 T2DM on chronic ASA therapy and to assess platelet
reactivity during long-term ASA therapy, we applied the point-of-care method VerifyNow®
aspirin test (Accumetrics, San Diego, CA, USA).

RESULTS: Compared with the low platelet reactivity (LPR) group, patients with HPR had
higher triglyceride levels (145 vs. 118 mg/dL, p = 0.041), were less frequently treated with
statins (57.1% vs. 75.3%; p = 0.038) and tumor necrosis factor-alpha (TNF-α) concentrations
were higher (2.15 vs. 1.74 pg/mL; p = 0.052). In a multivariate analysis only statin therapy
(OR 0.375; 95% CI 0.15-0.91; p = 0.030) and lower concentrations of TNF-α (for each
1.0 pg/mL: OR 1.3; 95% CI 1.00-1.72; p = 0.046) were predictive of LPR.

CONCLUSIONS: Our study provides indirect evidence that the beneficial effect of statins on
platelet activity may be related to their non-lipid-mediated, pleiotropic mechanisms of action.
This might have been partly related to decreased platelet reactivity in patients receiving statin
therapy. In our study in patients with T2DM, platelet reactivity on ASA therapy measured with
VerifyNow® was associated with TNF-α concentrations and statin therapy. These results may
imply a role for subclinical systemic inflammation and a beneficial effect of statins in the
development of HPR in T2DM. (Cardiol J 2012; 19, 5: 494-500)