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DOI: 10.1160/TH03-12-0738
ADP induced platelet degranulation in healthy individuals is reduced by clopidogrel after pretreatment with atorvastatin
Financial support: Dr. Schultheiss is supported by grants from Schering and Pfizer. Dr. Schwimmbeck and Dr. Rauch have received grants from Novoste. Dr. Rauch also received grants from the German Research Foundation. The support was not related to this study.Publikationsverlauf
Received
03. Dezember 2003
Accepted after resubmission
07. Juni 2004
Publikationsdatum:
30. November 2017 (online)
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Summary
Statins inhibit platelet reactivity and reduce blood thrombogenicity.The effectiveness of clopidogrel in inhibiting platelet reactivity was suggested to be reduced in the presence of atorvastatin due to shared enzymes in metabolism. Healthy individuals, 17 pretreated with atorvastatin (20 mg/d for 3 days) and 17 without pretreatment, as well as 15 patients with stable coronary artery disease (CAD) and concurrent atorvastatin therapy were started on clopidogrel (loading dose 300 mg, then 75 mg/d). P-selectin on platelet surface after stimulation with ADP or Thrombin Receptor Activating Peptide (TRAP) was flow cytometrically measured before and during clopidogrel administration. Whole blood platelet agglutination was tested by a platelet function assay.TRAP and - in trend - ADP induced p-selectin exposure was reduced by the atorvastatin pretreatment before clopidogrel was added. Combining clopidogrel with atorvastatin in the healthy individuals led to a further reduction in ADP-induced platelet p-selectin exposure. Clopidogrel also reduced platelet reactivity in CAD patients with concurrent atorvastatin medication. We conclude that pretreatment with atorvastatin reduces platelet reactivity before administration of clopidgrel. No drug interaction was seen, however, platelet inhibitory effects were observed during the treatment with clopidogrel and atorvastatin.
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