Inhibitors of 3-hydroxy-methyl-glutaryl coenzyme A reductase have been shown to reduce cardiovascular events in patients with raised and average serum cholesterol. 1, 2 It is unclear whether this effect is attributable solely to reduction of serum cholesterol or to other mechanisms. 3 We analysed whether simvastatin directly affects expression of monocyte tissue factor (TF).

After 4 weeks of diet alone (fat intake< 30% of total calories, cholesterol< 300 mg daily, polyunsaturated/saturated fatty acids ratio= 1· 0)(run-in phase), 24 patients (12 men and 12 women; mean age 52 [SD 8] range 35–70 years) with polygenic hypercholesterolaemia were randomised to simvastatin (20 mg daily) or to continue diet for 8 weeks. Before and after treatment, expression of TF antigen and activity as well as the circulating concentrations of prothrombin fragment F1+ 2, a marker of thrombin generation, were measured. Nine parts of blood were mixed in a pre-cooled