To cite this article: Biedermann JS, Cannegieter SC, Roest M, van der Meer FJM, Reitsma PH, Kruip MJHA, Lijfering WM. Platelet reactivity in patients with venous thrombosis who use rosuvastatin: a randomized controlled clinical trial. J Thromb Haemost 2016; 14: 1404-9.
Essentials• Statins, especially rosuvastatin, may reduce venous thrombosis risk, but the mechanism is unclear.• We performed a randomized trial investigating the effect of rosuvastatin on platelet reactivity.• Thromboxane-A2 mediated platelet aggregation was measured before and after rosuvastatin therapy.• Rosuvastatin did not inhibit thromboxane-mediated platelet aggregation in venous thrombosis patients.Summary. Background: Statins may exert a protective effect against the risk of venous thrombosis (VT), but the mechanism is unclear. Objectives: In this open-label, randomized clinical trial (www.clinicaltrials.gov NCT01613794), we aimed to determine the ex vivo effect of rosuvastatin on platelet reactivity in patients with a history of VT. Methods: Platelet reactivity, in platelet reaction units (PRUs), was measured at baseline and after 28 days with VerifyNow, which uses arachidonic acid to determine thromboxane-mediated platelet aggregation, in 50 consecutive patients included in our study (25 receiving rosuvastatin and 25 without intervention). Results: Forty-seven of 50 (94.0%) consecutively enrolled patients had two valid PRU measurements. The mean PRUs in rosuvastatin users were 609 at baseline and 613 at the end of the study (mean change 5; 95% confidence interval [CI] À 18 to 27). The mean PRUs in non-users were 620 at baseline and 618 at the end of the study (mean change À 2; 95% CI À 15 to 12). The mean difference in PRU change between users and non-users was 6 (95% CI À 20 to 33). After exclusion of patients who used antiplatelet medication, or had thrombocytopenia, similar results were obtained, i.e. no apparent effect of rosuvastatin on PRUs, with a mean difference in PRU change between users and non-users of À 1 (95% CI À 20 to 19). Conclusions: Rosuvastatin does not affect platelet reactivity when arachidonic acid is used as an agonist in patients with a history of VT.