[HTML][HTML] Statins improve the resolution of established murine venous thrombosis: reductions in thrombus burden and vein wall scarring

CW Kessinger, JW Kim, PK Henke, B Thompson… - PLoS …, 2015 - journals.plos.org
CW Kessinger, JW Kim, PK Henke, B Thompson, JR McCarthy, T Hara, M Sillesen
PLoS One, 2015journals.plos.org
Despite anticoagulation therapy, up to one-half of patients with deep vein thrombosis (DVT)
will develop the post-thrombotic syndrome (PTS). Improving the long-term outcome of DVT
patients at risk for PTS will therefore require new approaches. Here we investigate the
effects of statins—lipid-lowering agents with anti-thrombotic and anti-inflammatory properties—
in decreasing thrombus burden and decreasing vein wall injury, mediators of PTS, in
established murine stasis and non-stasis chemical-induced venous thrombosis (N= 282 …
Despite anticoagulation therapy, up to one-half of patients with deep vein thrombosis (DVT) will develop the post-thrombotic syndrome (PTS). Improving the long-term outcome of DVT patients at risk for PTS will therefore require new approaches. Here we investigate the effects of statins—lipid-lowering agents with anti-thrombotic and anti-inflammatory properties—in decreasing thrombus burden and decreasing vein wall injury, mediators of PTS, in established murine stasis and non-stasis chemical-induced venous thrombosis (N = 282 mice). Treatment of mice with daily atorvastatin or rosuvastatin significantly reduced stasis venous thrombus burden by 25% without affecting lipid levels, blood coagulation parameters, or blood cell counts. Statin-driven reductions in VT burden (thrombus mass for stasis thrombi, intravital microscopy thrombus area for non-stasis thrombi) compared similarly to the therapeutic anticoagulant effects of low molecular weight heparin. Blood from statin-treated mice showed significant reductions in platelet aggregation and clot stability. Statins additionally reduced thrombus plasminogen activator inhibitor-1 (PAI-1), tissue factor, neutrophils, myeloperoxidase, neutrophil extracellular traps (NETs), and macrophages, and these effects were most notable in the earlier timepoints after DVT formation. In addition, statins reduced DVT-induced vein wall scarring by 50% durably up to day 21 in stasis VT, as shown by polarized light microscopy of picrosirius red-stained vein wall collagen. The overall results demonstrate that statins improve VT resolution via profibrinolytic, anticoagulant, antiplatelet, and anti-vein wall scarring effects. Statins may therefore offer a new pharmacotherapeutic approach to improve DVT resolution and to reduce the post-thrombotic syndrome, particularly in subjects who are ineligible for anticoagulation therapy.
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