Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention

Rolf P Kreutz,1,2 Jeffrey A Breall,1 Anjan Sinha,1 Elisabeth von der Lohe,1 Richard J Kovacs,1 David A Flockhart,2,&dagger; 1Krannert Institute of Cardiology, 2Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA &dagger;David A Flockhart passed aw...

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Autores principales:	Kreutz RP, Breall JA, Sinha A, von der Lohe E, Kovacs RJ, Flockhart DA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Clopidogrel Atorvastatin Myocardial infarction Percutaneous coronary intervention Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/65db2ed8857346b4a69976f42d79a6b3
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spelling	oai:doaj.org-article:65db2ed8857346b4a69976f42d79a6b32021-12-02T02:54:25ZSimultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention1179-1438https://doaj.org/article/65db2ed8857346b4a69976f42d79a6b32016-06-01T00:00:00Zhttps://www.dovepress.com/simultaneous-administration-of-high-dose-atorvastatin-and-clopidogrel--peer-reviewed-article-CPAAhttps://doaj.org/toc/1179-1438Rolf P Kreutz,1,2 Jeffrey A Breall,1 Anjan Sinha,1 Elisabeth von der Lohe,1 Richard J Kovacs,1 David A Flockhart,2,&dagger; 1Krannert Institute of Cardiology, 2Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA &dagger;David A Flockhart passed away on November 26, 2015 Background: Reloading with high-dose atorvastatin shortly before percutaneous coronary interventions (PCIs) has been proposed as a strategy to reduce periprocedural myonecrosis. There has been a concern that statins that are metabolized by cytochrome P450 3A4 may interfere with clopidogrel metabolism at high doses. The impact of simultaneous administration of high doses of atorvastatin and clopidogrel on the efficacy of platelet inhibition has not been established. Methods: Subjects (n=60) were randomized to receive atorvastatin 80 mg together with clopidogrel 600 mg loading dose (n=28) versus clopidogrel 600 mg alone (n=32) at the time of PCI. Platelet aggregation was measured at baseline, 4 hours after clopidogrel loading dose, and 16–24 hours after clopidogrel loading dose by light transmittance aggregometry using adenosine diphosphate as agonist. Results: Platelet aggregation was similar at baseline in both the atorvastatin and the control groups (adenosine diphosphate 10 µM: 57%±19% vs 61%±21%; P=0.52). There was no significant difference in platelet aggregation between the atorvastatin and the control groups at 4 hours (37%±18% vs 39%±21%; P=0.72) and 16–24 hours post-clopidogrel loading dose (35%±17% vs 37%±18%; P=0.75). No significant difference in incidence of periprocedural myonecrosis was observed between the atorvastatin and control groups (odds ratio: 1.02; 95% confidence interval 0.37–2.8). Conclusion: High-dose atorvastatin given simultaneously with clopidogrel loading dose at the time of PCI does not significantly alter platelet inhibition by clopidogrel. Statin reloading with high doses of atorvastatin at the time of PCI appears to be safe without adverse effects on platelet inhibition by clopidogrel (ClinicalTrials.gov: NCT00979940). Keywords: clopidogrel, atorvastatin, myocardial infarction, percutaneous coronary intervention, platelet aggregationKreutz RPBreall JASinha Avon der Lohe EKovacs RJFlockhart DADove Medical PressarticleClopidogrelAtorvastatinMyocardial infarctionPercutaneous coronary interventionTherapeutics. PharmacologyRM1-950ENClinical Pharmacology: Advances and Applications, Vol 2016, Iss Issue 1, Pp 45-50 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Clopidogrel Atorvastatin Myocardial infarction Percutaneous coronary intervention Therapeutics. Pharmacology RM1-950
spellingShingle	Clopidogrel Atorvastatin Myocardial infarction Percutaneous coronary intervention Therapeutics. Pharmacology RM1-950 Kreutz RP Breall JA Sinha A von der Lohe E Kovacs RJ Flockhart DA Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention
description	Rolf P Kreutz,1,2 Jeffrey A Breall,1 Anjan Sinha,1 Elisabeth von der Lohe,1 Richard J Kovacs,1 David A Flockhart,2,&dagger; 1Krannert Institute of Cardiology, 2Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA &dagger;David A Flockhart passed away on November 26, 2015 Background: Reloading with high-dose atorvastatin shortly before percutaneous coronary interventions (PCIs) has been proposed as a strategy to reduce periprocedural myonecrosis. There has been a concern that statins that are metabolized by cytochrome P450 3A4 may interfere with clopidogrel metabolism at high doses. The impact of simultaneous administration of high doses of atorvastatin and clopidogrel on the efficacy of platelet inhibition has not been established. Methods: Subjects (n=60) were randomized to receive atorvastatin 80 mg together with clopidogrel 600 mg loading dose (n=28) versus clopidogrel 600 mg alone (n=32) at the time of PCI. Platelet aggregation was measured at baseline, 4 hours after clopidogrel loading dose, and 16–24 hours after clopidogrel loading dose by light transmittance aggregometry using adenosine diphosphate as agonist. Results: Platelet aggregation was similar at baseline in both the atorvastatin and the control groups (adenosine diphosphate 10 µM: 57%±19% vs 61%±21%; P=0.52). There was no significant difference in platelet aggregation between the atorvastatin and the control groups at 4 hours (37%±18% vs 39%±21%; P=0.72) and 16–24 hours post-clopidogrel loading dose (35%±17% vs 37%±18%; P=0.75). No significant difference in incidence of periprocedural myonecrosis was observed between the atorvastatin and control groups (odds ratio: 1.02; 95% confidence interval 0.37–2.8). Conclusion: High-dose atorvastatin given simultaneously with clopidogrel loading dose at the time of PCI does not significantly alter platelet inhibition by clopidogrel. Statin reloading with high doses of atorvastatin at the time of PCI appears to be safe without adverse effects on platelet inhibition by clopidogrel (ClinicalTrials.gov: NCT00979940). Keywords: clopidogrel, atorvastatin, myocardial infarction, percutaneous coronary intervention, platelet aggregation
format	article
author	Kreutz RP Breall JA Sinha A von der Lohe E Kovacs RJ Flockhart DA
author_facet	Kreutz RP Breall JA Sinha A von der Lohe E Kovacs RJ Flockhart DA
author_sort	Kreutz RP
title	Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention
title_short	Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention
title_full	Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention
title_fullStr	Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention
title_full_unstemmed	Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention
title_sort	simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/65db2ed8857346b4a69976f42d79a6b3
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Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention

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