A pharmacoepidemiology study of the interaction between atorvastatin and clopidogrel after percutaneous coronary intervention

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2005.08.023 Byline: James M. Brophy (a)(b), Mohan N. Babapulle (a), Vania Costa (b), Stephane Rinfret (c) Abstract: After percutaneous coronary intervention (PCI), the antiplatelet drug clopidogrel is frequently used to prevent stent thrombosis. A concern has been raised that atorvastatin may competitively inhibit the metabolism of the prodrug clopidogrel to its active metabolites by the cytochrome P450 3A4 (CYP3A4) enzyme, thereby potentially negating its antiplatelet effect. The 30-day rates of adverse cardiovascular events (composite of death, myocardial infarction, 11 unstable angina, stroke or transient ischemic attack, and repeat revascularization procedures) in unselected 12 patients prescribed clopidogrel after PCI as a function of their exposure to CYP3A4 inhibitors has not been fully resolved. Author Affiliation: (a) Division of Cardiology, Royal Victoria Hospital/McGill University Health Center, Montreal, Quebec, Canada (b) Division of Clinical Epidemiology, Royal Victoria Hospital/McGill University Health Center, Montreal, Quebec, Canada (c) Department of Medicine, HA[acute accent]pital Notre Dame/Centre HA[acute accent]spitalier de l'Universite de Montreal, Montreal, Quebec, Canada Article History: Received 20 April 2005; Accepted 15 August 2005