Absence of interaction between atorvastatin or other statins and clopidogrel

Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting

“…The interaction of statins with clopidogrel has been recently suggested but still remains controversial. 28,29 We were unable to substantiate an association between statin or other drug therapy and platelet inhibition on multivariable analysis.…”

Spectrum of Pleiotropic Effects of Statins in Heart Failure

“…PAR-1 is a thrombin receptor that is reduced in statin treated patients. [34,35] PAR-1 repression by all statins has been found to be nearly identical. [36] Simvastatin decreases the expression of tissue factor (TF) in a monocyte model of in vitro clotting.…”

Statins and Stroke

“…Recent studies suggested some statins that are metabolized via CYP450 isoenzyme 3A4 (i.e., atorvastatin, simvastatin, lovastastin) may inhibit the antiplatelet activity of clopidogrel, which is an inactive prodrug that requires liver metabolism and activation by CYP450 (Lau et al, 2003(Lau et al, , 2004). While some trials described an increase in cardiovascular morbidity and mortality in patients on clopidogrel prescribed atorvastatin versus other statin therapies (Wienbergen et al, 2003;Brophy et al, 2004) other clinical studies failed to show an effect on antiplatelet activity after concomitant use of statins with clopidogrel (Mü ller et al, 2003;Mitsios et al, 2004) and secondary analysis of randomized, placebo-controlled clopidogrel trials also did not show any adverse clinical interaction of clopidogrel with atorvastatin (Saw et al, 2003;Serebruany et al, 2004). Currently, there are no clear reasons to exclude the coadministration of these two classes of drugs in patients who are at high risk for coronary events (Bellosta et al, 2004).…”