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December 28, 2011Circulation JournalOpen Access

Endothelial Progenitor Cell Mobilization and Platelet Microparticle Release Are Influenced by Clopidogrel Plasma Levels in Stable Coronary Artery Disease

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Key result

Clopidogrel plasma levels were inversely correlated with platelet microparticle release (rho=-0.57) and positively correlated with endothelial progenitor cell mobilization in patients with stable coronary artery disease.

Why the study?

Does the combination of atorvastatin and clopidogrel influence endothelial progenitor cell mobilization and platelet microparticle release in patients with stable coronary artery disease?

Population

26 adults with stable coronary artery disease on stable statin therapy for at least 3 months, median age 63…

Comparison

Atorvastatin 80 mg daily and clopidogrel 75 mg… vs Within-subject comparison across different…

Design

Cohort, open-label

Follow-up

3 weeks

Authors

CFCarolina Nunes FrançaLPLuiz PinheiroMIMaria Cristina de Oliveira Izar

Discussion

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Overview

Should not yet change clopidogrel prescribing in stable CAD; leaves open whether these correlations reflect causal vascular protection or atorvastatin interaction.

Structured PICO

Does the combination of atorvastatin and clopidogrel influence endothelial progenitor cell mobilization and platelet microparticle release in patients with stable coronary artery disease?

P
Population
26 patients with stable coronary artery disease, aged 49-77 years, underwent a 3-week sequential treatment protocol with atorvastatin and clopidogrel to assess pharmacokinetic interactions and microparticle release.
I
Intervention
Atorvastatin 80 mg daily (visits 1-3) and clopidogrel 75 mg daily (visits 2-4) administered over 3 weeks in a sequential design (atorvastatin alone, atorvastatin + clopidogrel, clopidogrel alone).
C
Comparator
Within-subject comparison across different treatment phases (atorvastatin alone, atorvastatin + clopidogrel, clopidogrel alone).
O
Outcome
Counts of endothelial progenitor cells (EPC), endothelial microparticles (EMP), and platelet microparticles (PMP), and pharmacokinetic parameters over 24h at each visit.surrogate

Main Result

Effect estimate: rho=-0.57

p-value: p=0.006

Clopidogrel plasma levels inversely correlate with platelet microparticle release and positively correlate with endothelial progenitor cell mobilization, suggesting a potential vascular protective mechanism in stable CAD.

Limitations

  • Relatively small sample size
  • Study did not use a loading dose of clopidogrel, limiting extrapolation to other drug regimens
  • relatively small sample size
  • without a loading dose of clopidogrel, therefore the present results cannot be extrapolated to other drug regimens

Cite This Study

França et al. (2011) studied Stable coronary artery disease (n=26). Atorvastatin and Clopidogrel vs. Baseline and sequential monotherapy phases was evaluated on Correlation between clopidogrel maximum serum concentration (Cmax) and platelet microparticles (PMP) at visit 3 (rho=-0.57, p=0.006). Clopidogrel plasma levels were inversely correlated with platelet microparticle release (rho=-0.57) and positively correlated with endothelial progenitor cell mobilization in patients with stable coronary artery disease.

synapsesocial.com/papers/6a859396fc70cb81dc203322https://doi.org/10.1253/circj.cj-11-1145
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