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KMID : 0616620090150010011
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Journal of Soonchunhyang Medical College
2009 Volume.15 No. 1 p.11 ~ p.16
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Antiplatelet Activity of Clopidogrel was not Reduced by Long-term Coadministration of Atorvastatin Compared with Coadministration of Fluvastatin
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Park Mi-Hui
Kang You-Jin
Kim Soo-Min
Park Sul
Jeong Jae-Jin
Kim Goeng-Bae
Park Soo-Jin
Kim Jeong-Kyung
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Abstract
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Background:Recently there has been concern about the antiplatelet effect of clopidogrel which could be attenuated by atorvastatin due to shared enzyme in metabolism. However, recent reports showed concomitant short-term use of statins does not significantly inhibit antiplatelet activity of clopidogrel, We analyzed how two statins metabolized by different hepatic enzymatic pathway together with long-term use of clopidogrel affect platelet aggregation,
Methods:98 patients prior to or after coronary artery stenting due to stable angina or acute coronary syndrome with hyperlipidemia and they were divided into three groups: Group1 (n=32, clopidogrel t pravastatin 40 mg) , Group2 (n=33, clopidogrel 75 mg daily t atowastatin 10 mg [metabolized by cytochrome P450(CYP)3A4 daily], Group3 (n=33, clopidogrel 75 mg daily t fluvastatin 40 mg [metabolized by CYP2C9) daily]. All patients received aspirin and a loading dose of 300 mg of clopidogrel. Platelet aggregation was evaluated by two channel whole blood aggregometer in response to 5 pmollL of adenosine diphosphate.
Results:Baseline characteristics show no significant statistical difference between three groups at 95% confidence interval. Antiplatelet activity was 52.8 19.6% for before clopidogrel and were 26.4 1 10.9%, 27.8 +- 10.5% and 30.9 -4 11.7% for pravastatin, fluvastatin and atorvastatin plus clopidogrel, respectively. There was no significant difference between the platelet aggregation of each combination group (p)0.05), but comparing before clopidogrel to each of others (p(0.001).
Conculsions:Our data suggest that platelet aggregation was not affected by long-term coadministration of clopidogrel and atorvastatin or fluvastatin.
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KEYWORD
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Antiplatelet activity, Clopidogre, Atorvastatin, Percutaneous coronary intervention
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