title: Lack of clopidogrel-statin interaction in patients undergoing coronary stent implantation.
abstract: BACKGROUND
  Some studies have suggested reduced activity of clopidogrel on platelet activation and adherence in patients using statins.
  
  
  OBJECTIVE
  To assess whether platelet activation and aggregation decrease with clopidogrel, and whether there is a reduction of the action of clopidogrel when associated with atorvastatin or simvastatin.
  
  
  METHODS
  This prospective study included 68 patients with stable angina with previous use of simvastatin, atorvastatin, or no statin (control group), with previous elective indication of percutaneous coronary intervention (PCI). Platelet activation was analyzed by means of platelet count, levels of P-selectin and glycoprotein IIb/IIIa (with and without ADP stimulation) by flow cytometry. The findings were analyzed before and after percutaneous coronary intervention and the administration of clopidogrel.
  
  
  RESULTS
  We observed reduction in platelet activity with use of clopidogrel. Furthermore, no differences were found between the variables analyzed to prove reduced activity of clopidogrel when combined with statins. We observed levels of p-selectin (pre-angioplasty: 14.23 ± 7.52 x 8.83 x 11.45 ± 7.65 ± 7.09; after angioplasty: 21.49 ± 23.82 x 4 37 ± 2.71 x 4.82 ± 4.47, ρ < 0.01) and glycoprotein IIb/IIIa (pre-angioplasty: 98.97 ± 0.43 ± 1.25 x 98.79 x 99.21 ± 0.40 after angioplasty: 99.37 ± 0.29 ± 1.47 x 98.50 x 98.92 ± 0.88, ρ = 0.52), respectively, in the control, atorvastatin and simvastatin groups.
  
  
  CONCLUSIONS
  We concluded that platelet activation decreases with administration of clopidogrel, and clopidogrel has no antiplatelet effect reduced in the presence of simvastatin or atorvastatin.
authors: Hospital das Clínicas, Instituto do Coração, Universidade de São Paulo, Brazil.
authors: Carlos Vicente
authors: CV
authors: Serrano Júnior
authors: Alexandre de Matos
authors: Ade M
authors: Soeiro
authors: Leila Fernandes
authors: LF
authors: Araújo
authors: Bruna
authors: B
authors: Jabot
authors: Fabiana
authors: F
authors: Rached
authors: Noemia Mie
authors: NM
authors: Orii
authors: José Carlos
authors: JC
authors: Nicolau
authors: Alberto J
authors: AJ
authors: Duarte
authors: José Antonio F
authors: JA
authors: Ramires
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D000069059:Atorvastatin; D000077144:Clopidogrel; D004347:Drug Interactions; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000378:metabolism / Q000494:pharmacology; D011446:Prospective Studies; D011758:Pyrroles / Q000494:pharmacology*; D019821:Simvastatin / Q000494:pharmacology*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D000077144:Clopidogrel; D019821:Simvastatin; D013988:Ticlopidine