Background-Statins exert an antithrombotic effect in patients at risk of or with acute thrombosis, but no study has investigated whether this effect is immediate and whether there is an underline mechanism. Methods and Results-Patients with hypercholesterolemia were randomly allocated to a Mediterranean diet with low cholesterol intake (Ͻ300 mg/d; nϭ15) or atorvastatin (40 mg/d; nϭ15). Oxidative stress, as assessed by serum Nox2 and urinary isoprostanes, and platelet activation, as assessed by platelet recruitment, platelet isoprostanes, and thromboxane A 2 , platelet Nox2, Rac1, p47