Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention

Figures & data

Table 1 Baseline demographics and clinical variables

Variables	Atorvastatin (n=28)	Control (n=32)	P-value
Age (years)	62.6±10	61.4±8	0.6
Weight (kg)	97.9±32	103.7±48	0.58
Male sex (%)	22/28 (79%)	25/32 (78%)	0.97
Race			0.33
Caucasian (%)	22/28 (79%)	29/32 (91%)
African American (%)	5/28 (18%)	3/32 (9.4%)
Asian (%)	1/28 (4%)	0/32 (0%)
Prior CAD (%)	17/28 (61%)	22/32 (69%)	0.52
Congestive heart failure (%)	4/28 (14%)	5/32 (16%)	0.89
Diabetes mellitus (%)	13/28 (46%)	14/32 (44%)	0.84
Hypertension (%)	27/28 (96%)	30/31 (97%)	0.92
Hyperlipidemia (%)	25/28 (89%)	29/32 (91%)	0.86
Current smoking (%)	11/28 (39%)	10/32 (31%)	0.66
Baseline clopidogrel use (%)	7/28 (25%)	6/32 (19%)	0.56
Daily aspirin dose			0.6
81 mg	11/28 (39%)	12/32 (38%)
162 mg	0/28 (0%)	1/32 (3%)
325 mg	17/28 (61%)	9/32 (59%)
Prior treatment with simvastatin (%)	21/28 (75%)	22/32 (69%)	0.59
Proton pump inhibitor (%)	10/28 (36%)	13/32 (41%)	0.63
ACE inhibitors (%)	17/28 (61%)	20/32 (63%)	0.76
Beta blockers (%)	26/28 (93%)	26/32 (81%)	0.29
Calcium channel blockers (%)	6/28 (21%)	5/32 (16%)	0.6
Coronary artery intervention
Left anterior descending artery	9/28 (32%)	11/32 (34%)	0.86
Circumflex artery	8/28 (29%)	11/32 (34%)	0.63
Right coronary artery	14/28 (50%)	13/32 (41%)	0.47
Number of stents implanted	1.48±1.2	1.58±0.8	0.71

Notes: Data presented as mean ± standard deviation unless otherwise stated. Comparison of variables with Student’s t-test for continuous variables and χ² for categorical variables.

Abbreviations: CAD, coronary artery disease; ACE, angiotensin-converting enzyme.

Figure 1 Platelet aggregation.

Note: Maximal platelet aggregation measured at baseline (A), 4 hours (B), and 24 hours (C) after clopidogrel loading dose administration.
Abbreviation: ADP, adenosine diphosphate.

Figure 2 Platelet inhibition 4 hours (A) and 24 hours (B) after clopidogrel loading dose. Periprocedural myonecrosis after PCI (C).

Abbreviations: ADP, adenosine diphosphate; CK-MB, creatinine kinase-MB; PCI, percutaneous coronary intervention.

Table 2 Multivariable analysis of atorvastatin treatment with forward stepwise adjustment for baseline clinical variables and baseline clopidogrel and simvastatin treatment

Dependent variable: maximal platelet aggregation at 16–24 hours	B-value	95% Confidence interval	P-value
ADP 5 µM	−2.6	−11.2 to 5.9	0.54
ADP 10 µM	−0.7	−10.7 to 9.3	0.89
ADP 20 µM	−4.0	−13 to 5.1	0.39

Abbreviation: ADP, adenosine diphosphate.