Effect of Atorvastatin and Clopidogrel Co-Administration After Coronary Stenting in Korean Patients With Stable Angina

Background and Objectives: It was reported that atorvastatin co-administered with clopidogrel for 8 months did not affect the anti-platelet potency of clopidogrel in Korean patients with acute coronary syndrome, but not in patients with stable angina. We investigated whether co-administration of statins with clopidogrel affected the anti-platelet efficacy of clopidogrel in Korean patients with stable angina. Subjects and Methods: This was a randomized, open-label and two-period crossover design study conducted at two centers. Two hundreds thirty three patients with stable angina scheduled for coronary stenting were randomized into two groups. In Group A, 119 patients first received atorvastatin (10 mg) followed by fluvastatin (80 mg) for 12 weeks per treatment. In Group B, 114 patients received the same treatments in reverse order. Results: Baseline adenosine diphosphate (ADP, 10 $\mu$mol/L)-induced platelet aggregation was 54.4${\pm}$9.1% in Group A and 53.8${\pm}$9.0% in Group B (p=0.44), and significant differences were noted after each treatment period (p<0.001). Inhibition of platelet aggregation was similar between Group A and Group B at 24 hours following clopidogrel loading (29.2${\pm}$11.0% vs. 30.4${\pm}$12.7%; p=0.42). The two treatment least square means of 12-week ADP (10 mol/L)-induced platelet aggregation [29.50${\pm}$0.79 {standard error (SE)}% on the atorvastatin treatment group vs. 28.16${\pm}$0.70 (SE)% in the fluvastatin treatment group] in a 2${\times}$2 cross-over study were not significantly different (p=0.204). Conclusion: Statin and clopidogrel co-administration for 12 weeks is not associated with attenuated anti-platelet activity of clopidogrel in Korean patients with stable angina after coronary stenting, in support of the findings of similar studies conducted in Caucasian populations.