Undas A, Brummel-Ziedins K E, Mann K G
Anetta Undas, MD, PhD, Institute of Cardiology, Jagiellonian University School of Medicine, 80 Pradnicka St., 31-202 Krakow, Poland, Tel.: +48 12 6143004, Fax: +48 12 4233900, E-mail:
Thromb Haemost. 2014 Mar 3;111(3):392-400. doi: 10.1160/TH13-08-0720. Epub 2013 Nov 28.
There is evidence indicating that statins (3-hydroxy-methylglutaryl coenzyme A reductase inhibitors) may produce several cholesterol-independent antithrombotic effects. In this review, we provide an update on the current understanding of the interactions between statins and blood coagulation and their potential relevance to the prevention of venous thromboembolism (VTE). Anticoagulant properties of statins reported in experimental and clinical studies involve decreased tissue factor expression resulting in reduced thrombin generation and attenuation of pro-coagulant reactions catalysed by thrombin, such as fibrinogen cleavage, factor V and factor XIII activation, as well as enhanced endothelial thrombomodulin expression, resulting in increased protein C activation and factor Va inactivation. Observational studies and one randomized trial have shown reduced VTE risk in subjects receiving statins, although their findings still generate much controversy and suggest that the most potent statin rosuvastatin exerts the largest effect.
有证据表明，他汀类药物（3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂）可能产生多种不依赖于胆固醇的抗血栓形成作用。在本综述中，我们提供了关于他汀类药物与血液凝固之间相互作用的当前理解的最新信息，以及它们与预防静脉血栓栓塞（VTE）的潜在相关性。实验和临床研究中报道的他汀类药物的抗凝特性包括组织因子表达减少，导致凝血酶生成减少以及凝血酶催化的促凝反应减弱，如纤维蛋白原裂解、因子V和因子XIII激活，以及内皮血栓调节蛋白表达增强，导致蛋白C激活增加和因子Va失活。观察性研究和一项随机试验表明，接受他汀类药物治疗的受试者发生VTE的风险降低，尽管他们的研究结果仍存在很大争议，并且表明最有效的他汀类药物瑞舒伐他汀发挥的作用最大。
