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An interaction between statins and clopidogrel---A pharmacoepidemiology cohort study with survival time analysis

Posted on:2009-07-13Degree:M.ScType:Thesis
University:McGill University (Canada)Candidate:Blagojevic, AnaFull Text:PDF
GTID:2444390002492090Subject:Health Sciences
Abstract/Summary:
Clopidogrel is an antiplatelet drug prescribed to prevent stent thrombosis after a percutaneous coronary intervention (PCI). Previous evidence suggests that some widely prescribed statins may inhibit the antiplatelet effects of clopidogrel via competitive metabolism of its activating enzyme cytochrome P450 3A4 (CYP3A4).;We carried out a population-based cohort study identifying 10,491 patients using clopidogrel post-PCI (2001-2004). The outcome was a composite of death of any cause, myocardial infarction, unstable angina, repeat revascularization, and cerebrovascular events. We found that co-prescription of CYP3A4-metabolized statins (hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.79-1.15), or non-CYP3A4-metabolized statins (HR 0.82, 95% CI 0.63-1.07) with clopidogrel was not associated with increase in adverse outcomes.;We observed no evidence of interaction between clopidogrel and statins in a large population cohort of PCI patients, suggesting unlikelihood of an important interaction.;The objective was to investigate the possibility of an interaction post-PCI between statins and clopidogrel.
Keywords/Search Tags:Clopidogrel, Statins, Interaction, Cohort
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