Effect Of Clopidogrel On Aspirin Resistance And The Interaction With Statins

Objective (1) To observe the difference of the platelet aggregation rate between coadministration group and aspirin group in patients with acute coronary syndrome.and incidence of aspirin resistance,to show that clopidogrel can obviously reduce the aspirin resistance;(2) compared the differences of the platelet aggregation rate between clopidogrel coadministrated with different kinds of statins. To investigate the influence of statins on the antipatelet Action of clopidogrel.Methods (1)70 cases with ACS were divided into two groups,one is aspirin group ,30 cases received an oral loading dose of 300mg/ d of aspirin for 3 days ,followed by 100mg/d for 2weeks.the other is coadministration group,40 cases received aspirin plus clopidogrel of 75mg/d for 2weeks . turbidimetric method was used to Detection the adenosine diphosphate (ADP) and arach idonic acid (AA )induced platelet aggregation rate at 2 weeks. (2) coadministration group were randomly divided into two groups with two kinds of statins. both are20cases. In the first group, statins are metabolized by cytochrome P450(CYP)3A4, including Atorvastating 10-40mg/d or Simvastatin 40mg/d or Lovastatin 40mg/d, the senond group are not metabolized by cytochrome P450(CYP)3A4,such as Fluvastatin 80mg/d Pravastatin 20mg/d.the blood samples were detected the ADP induced platelet aggregation rate at 2weeks. Results coadministration group VS aspirin group ,two kinds of inductor induced average platelet aggregation rate decreased obviously(ADP induced platelet aggregation rate 51.65±9.42%VS59.94±12.68% P<0.001,AA induced 14.63±5.64%VS18.02±5.61% P<0.025) ,ADP induced platelet aggregation rate decreased lower,the total incidence of AR and ASR were lower in coadministration group than aspirin group (10%VS30% P<0.05);(2)there were no significant difference on antipatelet action of clopidogrel ( ADP induced 50.61±11.42% VS52.19±10.15% P>0.05) .Conclusion (1) coadministration of clopidogrel and aspirin can obviously reduce platelet resistance ,further reduce the adverse cardiovascular event ,so clopidogrel shoud be given earlier in ACS patients.(2) Clopidogrel coadministered Statins with routine doses are safety.whether Statins be or not metabolized by cytochrome P450(CYP)3A4, but when intensive lipid-lowering, coadministration should be careful.