International Journal of Cardiovascular Research

YALTA et al., Int J Cardiovasc Res 2014, 3:4
http://dx.doi.org/10.4172/2324-8602.1000171
International Journal of
Cardiovascular Research
Letter to Editor
A SCITECHNOL JOURNAL
The Impact of Statin Therapy on
Mean Platelet Volume and its
Seasonal Variation: is it Clinically
Relevant?
Kenan YALTA1*, Flora OZKALAYCI1, Mustafa YILMAZTEPE1, Bilal
GEYIK1, Nasir SIVRI1, and Ertan YETKIN2
1Trakya
2IMC
University, Cardiology Department, Edirne, Turkey
Hospital, Cardiology Department, Mersin, Turkey
*Corresponding Author: Kenan YALTA, Trakya University,
Department, Edirne, Turkey E-mail: [email protected]
Cardiology
Rec date: June 05, 2014 Acc date: August 11, 2014 Pub date: August 16,
2014
To the Editor
Seasonal variation in acute cardiovascular conditions and its
potential implications have drawn considerable interest in the recent
years. Accordingly, several studies have reported a variety of seasonal
peaks in the incidence of acute myocardial infarction (AMI)
particularly characterized by a winter predominance [1-3]. Moreover,
blood pressure [4] and a variety of humoral factors including
inflammation-coagulation markers [5-7] (well known promoters of
acute coronary syndromes (ACS) and stroke, etc.) were also previously
demonstrated to have a seasonal pattern partly accounting for the
seasonality of acute cardiovascular conditions [3]. In a similar manner,
thrombogenicity as measured with mean platelet volume (MPV) (a
well known index of platelet activation associated with ACSs, etc.)
[8,9] might also exhibit a seasonal variation [10] that might
hypothetically contribute to the seasonal variation in acute
cardiovascular conditions, to some extent, as well. On the other hand,
a variety of external factors with potential effects on platelet functions
(including drugs, etc.) might be expected to have a significant impact
on MPV, and possibly on its seasonal pattern [8,9] potentially
suggesting important clinical implications. However, as described
below, current data regarding the effects of cardiovascular drugs
(statins, etc.) on MPV are quite limited, and need to be substantiated
by further studies.
Among cardiovascular drugs, statins are well known to have a
variety of cholesterol-independent, namely pleiotropic effects
(favorable effects on endothelium, coagulation, etc.) that might be of
utmost importance for primary and secondary prevention of
cardiovascular diseases [9]. Our group has recently demonstrated that
both rosuvastatin and atorvastatin (in various alternative doses)
significantly and comparably decreased MPV values at one month
regardless of their cholesterol lowering effects among a population of
145 patients from an outpatient clinic [9]. Moreover, a previous study
also demonstrated significant effects of rosuvastatin therapy (10
mg/day for 12 weeks) on the reduction of MPV values irrespective of
its lipid lowering effects among hyperlipidemic patients [11]. Taken
together, these two studies [9,11] clearly demonstrated the favorable
effects of statins on platelet activation as manifested with significant
decreases in MPV values. Even though we suggested in our previous
study that potential effects of statins on MPV might be regarded as a
class effect (rather than being specific to certain molecules) due to the
general pleitropic effects of these agents [9], this issue has yet
remained to be established, and there may exist a significant variation
among a variety of statin molecules regarding their potential effects on
MPV.
On the other hand, MPV might appear to rise substantially in
certain subjects with or at risk for cardiovascular disease [8]
potentially exhibiting a seasonal variation in these subjects as well.
Accordingly, in a recently published article, MPV values in patients
with coronary artery disease (CAD) were found to be significantly
higher compared with control group, but failed to exhibit any seasonal
variation among these patients [8]. Even though the study was not
specifically designed to investigate the potential effects of
cardiovascular drugs on MPV and its seasonal pattern, the authors of
this study stated as one of their speculations that optimal medical
therapy including statins, beta blockers, angiotensin converting
enzyme inhibitors (ACE-I) etc, might have had significant effects on
MPV that might have led to the negation of seasonal variation in this
parameter among their study subjects with CAD as well [8]. As
described previously, there already exist relevant studies partly
confirming these speculations (at least regarding the effects of statin
therapy on MPV) [9,11]. However, the issues of whether seasonal
changes in MPV appear to correlate with seasonal variation in the
incidence of acute cardiovascular events including ACSs [8], and
accordingly the impact of certain cardiovascular drugs (including
statins) on MPV and its seasonal pattern would translate into any
clinical relevance remain speculative, and have yet remained to be
established.
Taken together, in a similar manner to seasonal fluctuations in
inflammation-coagulation markers [5-7], it seems possible that MPV
values might also exhibit a seasonal variation as previously
demonstrated in healthy elderly subjects [10]. However, drugs
including statins, irrespective of their lipid lowering effects, might
significantly diminish MPV [9,11] and its seasonal variation [8]. More
importantly, effects of statins on the seasonal pattern of MPV might
even appear to be more significant compared with their absolute
effects on this parameter. Finally, as a potential clinical implication;
statin users, in addition to being less likely to suffer from an acute
cardiovascular event, might not always demonstrate the typical
seasonal variation in acute cardiovascular conditions compared with
non-statin users possibly due to the suppressive effects of statin
therapy on MPV and its seasonal pattern, to some extent.
In summary, MPV has been suggested as a dynamic index of
platelet activation that might be significantly affected by a variety of
external factors including drugs, etc. [8,9]. Speculations have been
recently made regarding the effects of cardiovascular drug use on
MPV and its seasonal variation in patients with CAD [8]. Similarly, a
couple of previous studies [9,11] one of which was reported by our
group [9] demonstrated the significant effects of certain statin
molecules (atorvastatin, rosuvastatin) on MPV. Therefore,
notwithstanding the paucity of the current data, particular effects of
statin therapy on MPV appear to be evidence-based. As a clinical
implication, it may be suggested that statin-induced reduction in MPV
and its seasonal variation [8] might be regarded as part of well known
and favorable pleitropic actions of statin therapy [9] and that one
should not always expect the typical seasonal variation in the incidence
of acute cardiovascular events among statin users possibly due to the
impact of statin therapy on MPV and its seasonal pattern, to some
extent. However, further studies are still warranted to confirm the
effects of statins on MPV and its seasonal variation, and to investigate
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Citation:
YALTA K, OZKALAYCI F, YILMAZTEPE M, GEYIK B, SIVRI N, et al. (2014) The Impact of Statin Therapy on Mean Platelet Volume and its
Seasonal Variation: is it Clinically Relevant?. Int J Cardiovasc Res 3:4.
doi:http://dx.doi.org/10.4172/2324-8602.1000171
whether these effects might confer further clinical implications in the
setting of cardiovascular conditions.
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