Concomitant use of clopidogrel and statins and risk of major adverse cardiovascular events following coronary stent implantation
British Journal of Clinical Pharmacology,  Clinical Article

Schmidt M et al. – Clopidogrel and CYP3A4–metabolizing statin use were each associated with a substantially reduced rate of major adverse cardiovascular events (MACE) within 12 months after coronary stent implantation. Although authors observed an interaction between use of clopidogrel and statins, statin use vs. nonuse was not associated with an increased rate of MACE in patients using clopidogrel after coronary stent implantation.

Methods
  • Authors conducted this population–based cohort study in Western Denmark (population: 3 million) using medical databases.
  • They identified all 13,001 patients with coronary stent implantation between 2002 and 2005 and their comorbidities.
  • During 12–month follow–up, they tracked the use of clopidogrel and CYP3A4–metabolizing statins and the rate of MACE.
  • They used Cox regression to compute hazard ratios (HRs) controlling for potential confounders.

Results
  • The rate of MACE per 1000 person years was 104 for concomitant clopidogrel and statin use, 130 for clopidogrel without statin use, 108 for statin without clopidogrel use, and 446 for no use of either drug.
  • The adjusted HR comparing clopidogrel use with non–use was 0.68 (95% confidence interval (CI): 0.58–0.79) among statin users and 0.34 (95% CI: 0.29–0.40) among statin non–users, yielding an interaction effect (i.e., relative rate increase) of 1.97 (95% CI: 1.59–2.44).
  • The adjusted HR for MACE comparing statin use with non–use was 0.97 (95% CI: 0.83–1.13) among clopidogrel users and 0.49 (95% CI: 0.42–0.57) among clopidogrel non–users.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Family Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Family Medicine Articles

1 Association of fat density with subclinical atherosclerosis Full Text Journal of the American Heart Association, September 19, 2014    Free full text

2 Androgen deprivation therapy for prostate cancer is associated with cardiovascular morbidity and mortality: A meta-analysis of population-based observational studies PLOS ONE, October 3, 2014    Clinical Article

3 A comparison of different oral therapies versus no treatment for erectile dysfunction in 196 radical nerve-sparing radical prostatectomy patients International Journal of Impotence Research: The Journal of Sexual Medicine, August 12, 2014    Clinical Article

4 Rapid and durable protection against Ebola virus with new vaccine regimens Full Text National Institute of Allergy and Infectious Disease - News, September 9, 2014    Free full text

5 Prostate health index vs percent free prostate-specific antigen for prostate cancer detection in men with “gray” prostate-specific antigen levels at first biopsy: Systematic review and meta-analysis Translational Research, The Journal of Laboratory and Clinical Medicine, October 8, 2014    Clinical Article

6 Neuroendocrine prostate cancer (NEPC) progressing from conventional prostatic adenocarcinoma: Factors associated with time to development of NEPC and survival from NEPC diagnosis-a systematic review and pooled analysis Journal of Clinical Oncology, September 22, 2014    Evidence Based Medicine    Review Article

7 Transurethral intraprostatic injection of botulinum toxin type a for the treatment of chronic prostatitis/chronic pelvic pain syndrome: Results of a prospective pilot double-blind and randomized placebo-controlled study BJU International, October 24, 2014    Clinical Article

8 Single animal to human transmission event responsible for 2014 Ebola outbreak Full Text NIH News, September 2, 2014    Free full text

9 Dutasteride plus Tamsulosin fixed-dose combination first-line therapy versus Tamsulosin Monotherapy in the treatment of benign prostatic hyperplasia: A budget impact analysis in the Greek healthcare setting Full Text BMC Urology, October 1, 2014    Free full text    Clinical Article

10 Midlife dietary vitamin D intake and subsequent performance in different cognitive domains Annals of Nutrition and Metabolism, September 16, 2014    Clinical Article

11 Thiopurines and risk of colorectal neoplasia in patients with inflammatory bowel disease: A meta-analysis Clinical Gastroenterology and Hepatology , September 26, 2014    Evidence Based Medicine

12 Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: A meta-analysis Family Practice, October 1, 2014    Evidence Based Medicine

13 Aromatherapy for stress reduction in healthy adults: A systematic review and meta-analysis of randomized clinical trials Maturitas, September 3, 2014    Evidence Based Medicine

14 The effect of bupropion XL and escitalopram on memory and functional outcomes in adults with major depressive disorder: Results from a randomized controlled trial Psychiatry Research, August 4, 2014    Clinical Article

15 A randomized controlled study to evaluate the efficacy of tamsulosin monotherapy and its combination with mirabegron on patients with overactive bladder induced by benign prostatic obstruction The Journal of Urology, October 30, 2014    Clinical Article

16 Effect of anti-inflammatory treatment on depression, depressive symptoms, and adverse effects: A systematic review and meta-analysis of randomized clinical trials JAMA Psychiatry, October 21, 2014    Evidence Based Medicine    Clinical Article

17 Effect of reiki therapy on pain and anxiety in adults: an in-depth literature review of randomized trials with effect size calculations Pain Management Nursing, October 6, 2014    Review Article

18 Daily aspirin use and prostate cancer–specific mortality in a large cohort of men with nonmetastatic prostate cancer Journal of Clinical Oncology, October 24, 2014    Clinical Article

19 Early short-term doxycycline therapy in patients with acute myocardial infarction and left ventricular dysfunction to prevent the ominous progression to adverse remodelling: The TIPTOP trial Full Text European Heart Journal, October 18, 2013    Free full text    Clinical Article

20 Urinating standing versus sitting: Position is of influence in men with prostate enlargement. A systematic review and meta-analysis PLOS ONE, August 1, 2014    Evidence Based Medicine    Review Article
Exclusive Author Commentary

Indexed Journals in Family Medicine: American Family Physician, Archives of Family Med, Annals of Family Medmore