Müller Iris, Besta Felicitas, Schulz Christian, Li Zhongyan, Massberg Steffen, Gawaz Meinrad
Medizinische Klinik, Klinikum rechts der Isar und Deutsches Herzzentrum, Technische Universität München, Germany.
Circulation. 2003 Nov 4;108(18):2195-7. doi: 10.1161/01.CIR.0000099507.32936.C0. Epub 2003 Oct 20.
Recent studies suggested that some HMG-CoA reductase blockers might inhibit the antiplatelet activity of clopidogrel. Therefore, we analyzed how various statins together with a high loading dose of clopidogrel (600 mg) affect platelet aggregation.
Seventy-seven patients with stable angina scheduled for elective coronary stenting were studied. Patients were randomized to receive atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin (each 20 mg), cerivastatin (0.3 mg), or placebo, plus a high loading dose of 600 mg of clopidogrel. ADP-induced platelet aggregation (5 and 20 micromol/L) was determined before and 2 and 4 hours after first clopidogrel administration. All patients were taking aspirin (100 mg/d) regularly. We found that none of the statins significantly influenced inhibition of platelet aggregation by clopidogrel.
Concomitant use of statins with clopidogrel does not significantly inhibit antiplatelet activity, at least when clopidogrel is administered at a high loading dose of 600 mg.
近期研究表明，某些HMG-CoA还原酶阻滞剂可能会抑制氯吡格雷的抗血小板活性。因此，我们分析了各种他汀类药物与高负荷剂量氯吡格雷（600毫克）联合使用时对血小板聚集的影响。
对77例计划进行择期冠状动脉支架置入术的稳定型心绞痛患者进行了研究。患者被随机分为接受阿托伐他汀、氟伐他汀、洛伐他汀、普伐他汀、辛伐他汀（各20毫克）、西立伐他汀（0.3毫克）或安慰剂，外加600毫克高负荷剂量氯吡格雷。在首次服用氯吡格雷前以及服用后2小时和4小时测定ADP诱导的血小板聚集（5和20微摩尔/升）。所有患者均规律服用阿司匹林（100毫克/天）。我们发现，没有一种他汀类药物能显著影响氯吡格雷对血小板聚集的抑制作用。
他汀类药物与氯吡格雷联合使用不会显著抑制抗血小板活性，至少在氯吡格雷以600毫克高负荷剂量给药时如此。
