Interactions of statins with antithrombotic drugs

Due to a wealth of scientific clinical data, statins are being extensively used for the primary and secondary prevention of ischemic events. Therefore, statins play a major part in the pharmacological treatment of cardiovascular disease. Even before it became apparent that statins are effective despite normal baseline lipid levels, it was known that statins exert additional effects on the vascular wall that are independent of lipid lowering and protective toward the arteriosclerotic plaque. Some of these pleiotropic effects are related to hemostasis: through profibrinolytic, antiadhesive and antiaggregatory mechanisms, statins act antithrombotic. Based on experimental results, concerns were brought forward that atorvastatin interferes with the antithrombotic effects of the ADP-receptor inhibitor Prodrug, clopidogrel, due to competitive affinity to liver enzymes. So far, however, other experimental as well as clinical data do not support the hypothesis that atorvastatin or any other statin affects the antithrombotic potency of clopidogrel. The aforementioned issues will be discussed.