Influence of statin treatment on pharmacokinetics and pharmacodynamics of clopidogrel and its metabolites in patients after coronary angiography/angioplasty

Publication date: August 2019Source: Biomedicine & Pharmacotherapy, Volume 116Author(s): Marta Karaźniewicz-Łada, Janusz Rzeźniczak, Franciszek Główka, Adriana Gumienna, Filip Dolatowski, Marek Słomczyński, Paweł BurchardtAbstractPossible interaction between clopidogrel and CYP3A4-metabolised atorvastatin or non-CYP3A4-metabolised rosuvastatin was investigated based on pharmacokinetic parameters of clopidogrel and its metabolites as well as the platelet reactivity test in patients undergoing coronary angiography/angioplasty.The study involved 50 patients (62.7 ± 7.8 years old) who underwent coronary angiography/angioplasty and were treated with clopidogrel and atorvastatin or rosuvastatin during the six months after the procedure. The P2Y12 reaction units (PRU) and pharmacokinetic parameters of clopidogrel, diastereoisomers of thiol metabolite (inactive H3 and active H4), and inactive carboxylic metabolite were measured 12–18 h and six months after the coronary angiography/angioplasty.There were no significant differences in concentrations of clopidogrel and its metabolites including the H4 active metabolite in plasma of patients co-treated with clopidogrel and atorvastatin or rosuvastatin. The use of statins did not affect the pharmacokinetic parameters of the studied compounds. A significant correlation was found between the Cmax and AUC0-t of the active H4 isomer and platelet aggregation in a group of patients treated with rosuvastatin but not in the atorv...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research