The antiplatelet effect of atorvastatin in patients with acute coronary syndrome depends on the hs-CRP level.
BACKGROUND
In data we published earlier, there is a correlation between platelet aggregation in patients with acute coronary syndrome (ACS) who are receiving aspirin and elevated hsCRP-level. We suggested that antiplatelet action of statins, which are known to lower hsCRP-levels, could be especially pronounced in patients with high levels of hsCRP.


RESULTS
54 patients with ACS without ST-segment elevation were included in this study. All patients received aspirin 160-325 mg daily. In addition to aspirin, some patients received atorvastatin 40-80 mg/d (n=19) or 300 mg of clopidogrel followed by 75 mg/d (n=15). HsCRP-levels and ADP-induced platelet aggregation were assessed on the first and on the eight days of treatment. Patients were divided into subgroups according to initial hsCRP-levels and treatment. In atorvastatin/high-CRP subgroup, the level of aggregation was about three times lower after eight days than it was on the first day. In contrast, in atorvastatin/low-CRP subgroup the level of platelet aggregation did not change during the same period. The effect of clopidogrel did not depend on hsCRP-level. In control group (patients treated with aspirin alone), platelet aggregation did not change with time.


CONCLUSIONS
There is a correlation between antiplatelet effect of atorvastatin and initial hsCRP-level. The antiplatelet effect of clopidogrel does not depend on hsCRP-level.
Vasilieva
Elena
E
Department of Cardiology, Moscow State University of Medicine and Dentistry, Moscow, Russia. elena_vasilieva@list.ru
Kasyanova
Olga
O
Shpektor
Alexander
A
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000503:physiopathology; D000368:Aged; D001241:Aspirin / Q000494:pharmacology; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000032:analysis*; D000077144:Clopidogrel; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects* / Q000502:physiology; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D011758:Pyrroles / Q000494:pharmacology*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000494:pharmacology
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D011758:Pyrroles; D002097:C-Reactive Protein; D000069059:Atorvastatin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin