TY - JOUR
T1 - Pharmacodynamic comparison of pitavastatin versus atorvastatin on platelet reactivity in patients with coronary artery disease treated with dual antiplatelet therapy
T2 - The PORTO trial
AU - Pelliccia, Francesco
AU - Rosano, Giuseppe
AU - Marazzi, Giuseppe
AU - Vitale, Cristiana
AU - Spoletini, Ilaria
AU - Franzoni, Ferdinando
AU - Speziale, Giuseppe
AU - Polacco, Marina
AU - Greco, Cesare
AU - Gaudio, Carlo
PY - 2014
Y1 - 2014
N2 - 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
AB - 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
KW - Clopidogrel
KW - Coronary artery disease
KW - Percutaneous coronary intervention
KW - Platelet reactivity
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U2 - 10.1253/circj.CJ-13-1216
DO - 10.1253/circj.CJ-13-1216
M3 - Article
C2 - 24389597
AN - SCOPUS:84894466932
VL - 78
SP - 679
EP - 684
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 3
ER -