Thromb Haemost 2005; 94(02): 438-443
DOI: 10.1160/TH05-01-0046
Cell Signalling and Vessel Remodelling
Schattauer GmbH

The antiplatelet effect of clopidogrel is not attenuated by statin treatment in stable patients with ischemic heart disease

Pernille Vinholt
1   Department of Cardiology, Odense University Hospita
,
Tina Svenstrup Poulsen
1   Department of Cardiology, Odense University Hospita
,
Lars Korsholm
2   Department of Statistics, University of Southern Denmark
,
Søren Risom Kristensen
3   Department KKA, Clinical Chemistry, Odense University Hospital
,
Jesper Hallas
4   Department of Internal Medicine, Odense University Hospital
,
Per Damkier
5   Department KKA, Clinical Pharmacology, Odense University Hospital, Odense, Denmark
,
Hans Mickley
1   Department of Cardiology, Odense University Hospita
› Institutsangaben
Grant support was provided by The Danish Heart Foundation (04–4–3-B50-A49–22167), “IngeniØr KA Rohdes Legat”, “Herta Christensens Fond” and “Aase og Ejnar Danielsens Fond”.
Weitere Informationen

Publikationsverlauf

Received: 20. Januar 2005

Accepted after major revision: 07. Mai 2005

Publikationsdatum:
05. Dezember 2017 (online)

Summary

Recent studies suggest that cytochrome P450 (CYP) 3A4 metabolized statins attenuate the antiaggregatory effect of clopidogrel. We evaluated how CYP3A4 metabolized statins and non- CYP3A4 metabolized statins influence platelet aggregation when given concomitantly with clopidogrel. Sixty-six stable patients with ischemic heart disease were included in this parallel group study. All patients were on clopidogrel and aspirin. Thirty-three patients received a CYP3A4 metabolized statin (simvastatin or atorvastatin), and 33 were treated with a non- CYP3A4 metabolized statin (pravastatin). The antiplatelet effect of clopidogrel was assessed at inclusion and 21 days after statin discontinuation. Platelet function was evaluated by two methods 1) optical platelet aggregometry after stimulation with 20 and 30 μM ADP, and 2 and 4 mg/l collagen, respectively, 2) a Platelet FunctionAnalyzer-100. The primary effect measure was final platelet aggregation after stimulation with 20 μM ADP. No difference was observed between patients treated with a CYP3A4 metabolized statin and patients receiving a non-CYP3A4 metabolized statin (30% point (7–42) versus 20% point (9–32), p=0.83). Platelet aggregation was not improved by discontinuation of statins for 21 days. Indeed, we found that statin treatment given concomitantly with clopidogrel resulted in an improved platelet inhibition when compared to clopidogrel given alone. The antiplatelet effect of clopidogrel is not attenuated by concomitant treatment with a CYP3A4 metabolized statin in patients with clinical stable ischemic heart disease.

 
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