The antiplatelet effect of atorvastatin in patients with acute coronary syndrome depends on the hs-CRP level

BACKGROUND: In data we published earlier, there is a correlation between platelet aggregation in patients with acute coronary syndrome (ACS) who are receiving aspirin and elevated hsCRP-level. We suggested that antiplatelet action of statins, which are known to lower hsCRP-levels, could be especially pronounced in patients with high levels of hsCRP. METHODS AND RESULTS: 54 patients with ACS without ST-segment elevation were included in this study. All patients received aspirin 160-325 mg daily. In addition to aspirin, some patients received atorvastatin 40-80 mg/d (n=19) or 300 mg of clopidogrel followed by 75 mg/d (n=15). HsCRP-levels and ADP-induced platelet aggregation were assessed on the first and on the eight days of treatment. Patients were divided into subgroups according to initial hsCRP-levels and treatment. In atorvastatin/high-CRP subgroup, the level of aggregation was about three times lower after eight days than it was on the first day. In contrast, in atorvastatin/low-CRP subgroup the level of platelet aggregation did not change during the same period. The effect of clopidogrel did not depend on hsCRP-level. In control group (patients treated with aspirin alone), platelet aggregation did not change with time. CONCLUSION: There is a correlation between antiplatelet effect of atorvastatin and initial hsCRP-level. The antiplatelet effect of clopidogrel does not depend on hsCRP-level.