Statins do not affect platelet inhibition with clopidogrel during coronary stenting

Serebruany, Victor L.; Malinin, Alex I.; Callahan, Kevin P.; Gurbel, Paul A.; Steinhubl, Steven R.

doi:10.1016/s0021-9150(01)00606-2

Cited by 54 publications

(45 citation statements)

References 6 publications

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“…We did not find any significant influence of either lipophilic or hydrophilic statins on platelet inhibition by clopidogrel, which is consistent with a previous report in which a loading dose of 300 mg of clopidogrel was administered. 11 The present study cannot rule out the possibility that long-term administration of statins may interfere with clopidogrel. However, recent data from the Interaction of Atorvastatin and Clopidogrel Trial 12 show that atorvastatin does not affect the antiplatelet properties of clopidogrel in patients treated with statins for 30 days.…”

Section: Demographic and Clinical Characteristics Of Patientsmentioning

confidence: 68%

Effects of Statins on Platelet Inhibition by a High Loading Dose of Clopidogrel

et al. 2003

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Background-Recent studies suggested that some HMG-CoA reductase blockers might inhibit the antiplatelet activity of clopidogrel. Therefore, we analyzed how various statins together with a high loading dose of clopidogrel (600 mg) affect platelet aggregation. Methods and Results-Seventy-seven patients with stable angina scheduled for elective coronary stenting were studied.Patients were randomized to receive atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin (each 20 mg), cerivastatin (0.3 mg), or placebo, plus a high loading dose of 600 mg of clopidogrel. ADP-induced platelet aggregation (5 and 20 mol/L) was determined before and 2 and 4 hours after first clopidogrel administration. All patients were taking aspirin (100 mg/d) regularly. We found that none of the statins significantly influenced inhibition of platelet aggregation by clopidogrel. Conclusions-Concomitant use of statins with clopidogrel does not significantly inhibit antiplatelet activity, at least when clopidogrel is administered at a high loading dose of 600 mg.

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Section: Demographic and Clinical Characteristics Of Patientsmentioning

confidence: 68%

Effects of Statins on Platelet Inhibition by a High Loading Dose of Clopidogrel

et al. 2003

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“…61 Conflicting data have been reported on the effect of statins on clopidogrel-inhibited platelet aggregation in patients undergoing coronary stenting; at the moment, 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. [62][63][64][65] …”

Section: Other Statin Interactionsmentioning

confidence: 99%

Safety of Statins

2004

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Abstract-Statin monotherapy is generally well tolerated, with a low frequency of adverse events. The most important adverse effects associated with statins are myopathy and an asymptomatic increase in hepatic transaminases, both of which occur infrequently. Because statins are prescribed on a long-term basis, however, possible interactions with other drugs deserve particular attention, as many patients will typically receive pharmacological therapy for concomitant conditions during the course of statin treatment.

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“…The first authors to reject the existence of a potential clinically relevant interaction between statins and clopidogrel were Serebruany et al (2001). In a Letter to the Editors they described retrospectively analysed data from the PRONTO (Plavix Reduction of New Thrombus Occurrence) trial (Gurbel et al 2003a).…”

Section: Studies With Surrogate End-pointsmentioning

confidence: 99%

“…The clinical relevance of a potential drug-drug interaction between clopidogrel and statins, primarily atorvastatin, has recently been subject to much controversy and discussion (Lau et al 2000(Lau et al & 2003Serebruany et al 2001;Clarke & Waskell 2003;Müller et al 2003;Neubauer et al 2003;Saw et al 2003;Wienbergen et al 2003;Mitsios et al 2004). Clopidogrel is an antiplatelet agent that has a proven efficacy in decreasing the incidence of myocardial infarction, stroke, vascular death and coronary artery stent thrombosis in patients with cardiovascular atherosclerotic disease (CA-PRIE Steering Committee 1996; Bertrand et al 2000;The CURE trial Investigators 2001).…”

mentioning

confidence: 99%

Existence of a Clinically Relevant Interaction between Clopidogrel and HMG‐CoA Reductase Inhibitors? Re‐evaluating the Evidence

Poulsen

Vinholt

Mickley

et al. 2005

Basic Clin Pharma Tox

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Abstract:Clopidogrel is an inactive prodrug, which requires activation by the cytochrome P450 3A4 system in order to exert its antiplatelet action. Some statins (atorvastatin, lovastatin and simvastatin) also requires metabolism by the cytochrome P450 3A4 system. From a theoretical point of view, a clinical relevant interaction may exist between clopidogrel and cytochrome P450 3A4 metabolized statins. Nine studies have investigated the existence of this potential interaction. Seven studies have used results based on platelet function as surrogate endpoints and two studies have dealt with objective clinical events including mortality, acute myocardial infarction and stroke. However the studies have yielded conflicting results. This controversy is primarily caused by substantial differences in study design and methods used for assessment of the antiaggregatory effect of clopidogrel. Most studies have included too few patients, and there appears to be no consensus regarding the definition of and optimal way of measuring the platelet inhibitory effect of clopidogrel. Therefore an adequately powered prospective study, ensuring elimination of identified possible confounders and with the use of a well-defined surrogate ex vivo parameter should be performed.

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Statins do not affect platelet inhibition with clopidogrel during coronary stenting

Cited by 54 publications

References 6 publications

Effects of Statins on Platelet Inhibition by a High Loading Dose of Clopidogrel

Effects of Statins on Platelet Inhibition by a High Loading Dose of Clopidogrel

Safety of Statins

Existence of a Clinically Relevant Interaction between Clopidogrel and HMG‐CoA Reductase Inhibitors? Re‐evaluating the Evidence

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