Pharmacodynamic comparison of pitavastatin versus atorvastatin on platelet reactivity in patients with coronary artery disease treated with dual antiplatelet therapy: The PORTO trial

Francesco Pelliccia, Giuseppe Rosano, Giuseppe Marazzi, Cristiana Vitale, Ilaria Spoletini, Ferdinando Franzoni, Giuseppe Speziale, Marina Polacco, Cesare Greco, Carlo Gaudio

Research output: Contribution to journalArticlepeer-review

Abstract

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 75 mg plus aspirin 100 mg) entered the PORTO trial. Patients were randomly assigned to atorvastatin (20 mg day) or pitavastatin (4 mg 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

Original languageEnglish
Pages (from-to)679-684
Number of pages6
JournalCirculation Journal
Volume78
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Clopidogrel
  • Coronary artery disease
  • Percutaneous coronary intervention
  • Platelet reactivity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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