Impact of statins on clopidogrel platelet inhibition in patients with acute coronary syndrome or stable angina / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>This prospective registered study was conducted to investigate the impact of statins (pravastatin, fluvastatin, atorvastatin) on clopidogrel platelet inhibition in patients with acute coronary syndrome (ACS) or stable angina.</p><p><b>METHODS</b>A total of 1015 consecutive patients with ACS or stable angina underwent coronary angiography/percutaneous coronary intervention (PCI) were allocated to pravastatin group (n = 228), fluvastatin group (n = 179), atorvastatin group (n = 481) or placebo control group (n = 127). Baseline characteristics, coronary angiography/PCI features and acute stent thrombosis, platelet aggregation induced by 2, 5, 10 and 20 micromol adenosine diphosphate (ADP) at 1 minute (ADP-1), 5 minutes (ADP-5) and maximal platelet aggregation (ADP-M) were compared among groups.</p><p><b>RESULTS</b>Baseline and procedural characteristics were comparable among the four groups. Acute stent thrombosis (pravastatin group 0.9%, fluvastatin group 1.1%, atorvastatin group 1.0% and control group 0.8%, all P > 0.05), ADP-1, ADP-5, and ADP-M (all P > 0.05) were also similar among groups. Multivariate liner and ordinal logistic analysis revealed that age (B = 0.21, P = 0.001), dose of clopidogrel (B = 7.30, P = 0.002) and use of low-molecular heparin (OR = 6.71, P = 0.01) were independent factors for platelet aggregation inhibition efficacy by clopidogrel.</p><p><b>CONCLUSION</b>Inhibition of platelet aggregation with clopidogrel was influenced by age, clopidogrel dose and low-molecular heparin but not by various statin treatments.</p>