Comparison of Low vs Moderate Dose of Atorvastatin in Clopidogrel Resistance After Coronary Stenting in Korean Patients With Acute Coronary Syndrome

摘要

Background: The effect of atorvastatin lOmg vs 40 mg in clopidogrel resistance and clinical events after coronary stenting was compared in patients with acute coronary syndrome (ACS).Methods and Results: Platelet aggregation was measured before clopidogrel administration and 4h, 24h, 5 days, and 8 months later in 130 ACS patients. Stented patients were randomly assigned to atorvastatin either 10 mg (n=65) or 40 mg (n=65), and received an oral loading dose of 300 mg of clopidogrel followed by 75mg/day for 8 months. Measurement of platelet aggregation was done by the turbimetric method. The mean % changes in inhibition of platelet aggregation were 35.5(+-)8.3, 50.9(+-)10.1, 38.3+8.3,40.0(+-)6.8 in the Atorvastatin lOmg Group and 31.017.6,43.7(+-)9.8,45.0(+-)10.3,43.5(+-)7.8 (4h, 24h, 5 days, and 8 months, respectively, after 300mg of clopidogrel pretreatment) in the Atorvastatin 40 mg Group with no significant differences between the 2 groups. Cardiovascular events showed no significant differences during the follow-up.Conclusions: Atorvastatin lOmg or 40mg co-administered with clopidogrel for 8 months did not affect the anti-platelet potency of clopidogrel and showed no significant differences in the clinical events in ACS patients.