Pharmacodynamic Comparison of Pitavastatin Versus Atorvastatin on Platelet Reactivity in Patients With Coronary Artery Disease Treated With Dual Antiplatelet Therapy:– The PORTO Trial –

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概要

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• Background: Levels of platelet reactivity in patients on dual antiplatelet therapy (DAPT) can be influenced by concomitant treatment with statins. We verified if the pharmacodynamic effects of CYP3A4-metabolized statins (atorvastatin) and non-CYP3A4-metabolized statins (pitavastatin) differ in patients with coronary artery disease (CAD) treated with DAPT. Methods and Results: A total of 155 CAD patients receiving DAPT (clopidogrel 75mg plus aspirin 100mg) entered the PORTO trial. Patients were randomly assigned to atorvastatin (20mg day) or pitavastatin (4mg day) for 30 days, and then switched to the other drug for 30 days. Platelet reactivity was expressed as VerifyNow P2Y12 platelet response units (PRU) before and after each 30-day treatment period. High platelet reactivity was defined as PRU >208. As compared with pretreatment (192±49), PRU was significantly higher after 30-day atorvastatin (210±56; P=0.003), but was unchanged after 30-day pitavastatin (199±47 PRU, NS). In the 48 patients with PRU >208 at baseline (232±44), PRU increased significantly after 30-day atorvastatin (258±41, P=0.004), but not after 30-day pitavastatin (237±43, NS). In the 107 patients with PRU <208 at baseline (174±52), PRU did not change significantly with respect to baseline either after 30-day atorvastatin (188±61, NS) or after 30-day pitavastatin (181±59, NS). Conclusions: Pitavastatin, a non-CYP3A4-metabolized statin, does not affect clopidogrel's response as compared with atorvastatin in patients who are borderline or poor responders to DAPT.

著者

• Vitale Cristiana

  Medical Science Departement, IRCCS San Raffaele Pisana

• Greco Cesare

  Department "Attilio Reale", Sapienza University

• Rosano Giuseppe

  Medical Science Departement, IRCCS San Raffaele Pisana

• Pelliccia Francesco

  Department "Attilio Reale", Sapienza University

• Marazzi Giuseppe

  Medical Science Departement, IRCCS San Raffaele Pisana

• Spoletini Ilaria

  Medical Science Departement, IRCCS San Raffaele Pisana

• Franzoni Ferdinando

  Department of Internal Medicine, University of Pisa

• Speziale Giuseppe

  Anthea Hospital, GVM Care & Research, ES Health Science Foundation

• Polacco Marina

  Department "Attilio Reale", Sapienza University

• Gaudio Carlo

  Department "Attilio Reale", Sapienza University

• Polacco Marina

  Department "Attilio Reale", Sapienza University

• Speziale Giuseppe

  Anthea Hospital, GVM Care & Research, ES Health Science Foundation

関連論文

• Endothelial Progenitor Cells Predict Long-Term Prognosis in Patients With Stable Angina Treated With Percutaneous Coronary Intervention:– Five-Year Follow-up of the PROCREATION Study –
• Pharmacodynamic Comparison of Pitavastatin Versus Atorvastatin on Platelet Reactivity in Patients With Coronary Artery Disease Treated With Dual Antiplatelet Therapy:– The PORTO Trial –

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