Enhanced Interleukin-1β in Hypercholesterolemia

Background— This study was aimed at verifying whether activation of platelets might represent a source of interleukin (IL)-1β levels in hypercholesterolemia. To this purpose, we compared the effects of a short-term treatment with simvastatin or low-dose aspirin on circulating levels of this cytokine. Methods and Results— Fifty patients with hypercholesterolemia were randomly allocated to receive an 8-week therapeutic course of simvastatin 20 mg daily (n=25) or aspirin 100 mg daily (n=25). Baseline soluble (s) P-selectin directly correlated with IL-1β ( P <0.0001) and C-reactive protein (CRP) ( P <0.05) but not with von Willebrand factor, total cholesterol, or LDL cholesterol levels. Furthermore, sP-selectin ( P <0.02) and IL-1β ( P <0.0001) levels were independently related to CRP by multiple regression analysis. Both drugs were associated with comparable, significant reductions in IL-1β and sP-selectin. Simvastatin, but not aspirin treatment, significantly lowered CRP levels ( P <0.05). The change in IL-1β levels correlated with the change in sP-selectin in patients randomized to either simvastatin (Rho, 0.42; P <0.05) or aspirin (Rho, 0.42; P <0.05). In contrast, the simvastatin-induced change in IL-1β did not correlate with the change in CRP levels. Conclusions— This study suggests that platelets might contribute to IL-1β production in hypercholesterolemia, thus providing an additional link between inflammation and the prothrombotic state in this setting.