Lack of Clopidogrel-Statin Interaction in Patients Undergoing Coronary Stent Implantation

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, p < 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, p = 0.52), respectively, in the control, atorvastatin and simvastatin groups. Conclusion: We concluded that platelet activation decreases with administration of clopidogrel, and clopidogrel has no antiplatelet effect reduced in the presence of simvastatin or atorvastatin. (Arq Bras Cardiol 2010; 95(3) : 321-327)