PMID- 23428009
OWN - NLM
STAT- MEDLINE
DCOM- 20130812
LR  - 20181202
IS  - 1876-7605 (Electronic)
IS  - 1936-8798 (Linking)
VI  - 6
IP  - 2
DP  - 2013 Feb
TI  - High-dose atorvastatin on the pharmacodynamic effects of double-dose clopidogrel 
      in patients undergoing percutaneous coronary interventions: The ACHIDO 
      (Atorvastatin and Clopidogrel HIgh DOse in stable patients with residual high 
      platelet activity) study.
PG  - 169-79
LID - S1936-8798(12)01172-7 [pii]
LID - 10.1016/j.jcin.2012.09.013 [doi]
AB  - OBJECTIVES: The goal of this study was to investigate the impact of high-dose 
      atorvastatin on the pharmacodynamic (PD) effects of double-dose clopidogrel in 
      statin-naive patients with stable coronary artery disease (CAD) and 
      high-on-treatment platelet reactivity (HTPR) while on standard-dose clopidogrel 
      before percutaneous coronary intervention (PCI). BACKGROUND: Patients with HTPR 
      are at increased risk of adverse cardiovascular events after PCI. High-dose 
      statins improve prognosis in high-risk patients by lipid- and nonlipid-related 
      mechanisms, including antithrombotic effects. METHODS: The ACHIDO (Atorvastatin 
      and Clopidogrel HIgh DOse in stable patients with residual high platelet 
      activity) study was a randomized PD study of high-dose (80 mg) atorvastatin in 
      addition to double-dose (150 mg) clopidogrel (atorvastatin group, n = 38) versus 
      double-dose clopidogrel alone (control group, n = 38) in patients with HTPR. HTPR 
      was defined as P2Y(12) reaction units (PRU) >/=235 by the VerifyNow P2Y12 assay. 
      Platelet reactivity was evaluated immediately before PCI and at 10 and 30 days. 
      RESULTS: Patients randomized to atorvastatin had lower PRU values (188 +/- 48 vs. 
      223 +/- 53 PRU, p < 0.01; primary endpoint) and HTPR rates (16% vs. 42%, p < 0.01) 
      at 30 days than patients in the control group. Statin treatment (odds ratio [OR]: 
      3.8, p = 0.011), baseline PRU <298 (OR: 10.7, p = 0.0001), noncarrier status of 
      CYP2C19*2 loss-of-function allele (OR: 2.9, p = 0.043), and age (OR: 0.94, p = 
      0.032) were variables significantly associated with optimal PD response (PRU 
      <235) at 30 days. No correlations were found between PRU and lipid fractions. 
      CONCLUSIONS: High-dose atorvastatin significantly improved the PD effects of 
      double-dose clopidogrel in our stable CAD patients with HTPR undergoing PCI 
      (Atorvastatin and Clopidogrel HIgh DOse in stable patients with residual high 
      platelet activity [ACHIDO]; NCT01335048).
CI  - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Leoncini, Mario
AU  - Leoncini M
AD  - Division of Cardiology, Misericordia e Dolce Hospital, Prato, Italy. 
      leoncini.mario@tiscali.it
FAU - Toso, Anna
AU  - Toso A
FAU - Maioli, Mauro
AU  - Maioli M
FAU - Angiolillo, Dominick J
AU  - Angiolillo DJ
FAU - Giusti, Betti
AU  - Giusti B
FAU - Marcucci, Rossella
AU  - Marcucci R
FAU - Abbate, Rosanna
AU  - Abbate R
FAU - Bellandi, Francesco
AU  - Bellandi F
LA  - eng
SI  - ClinicalTrials.gov/NCT01335048
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JACC Cardiovasc Interv
JT  - JACC. Cardiovascular interventions
JID - 101467004
RN  - 0 (Heptanoic Acids)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (P2RY12 protein, human)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Purinergic P2Y Receptor Antagonists)
RN  - 0 (Pyrroles)
RN  - 0 (Receptors, Purinergic P2Y12)
RN  - A0JWA85V8F (Atorvastatin)
RN  - A74586SNO7 (Clopidogrel)
RN  - EC 1.14.14.1 (Aryl Hydrocarbon Hydroxylases)
RN  - EC 1.14.14.1 (CYP2C19 protein, human)
RN  - EC 1.14.14.1 (Cytochrome P-450 CYP2C19)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
CIN - JACC Cardiovasc Interv. 2013 Feb;6(2):180-1. PMID: 23428010
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Aryl Hydrocarbon Hydroxylases/genetics
MH  - Atorvastatin
MH  - Blood Platelets/*drug effects/metabolism
MH  - Chi-Square Distribution
MH  - Clopidogrel
MH  - Coronary Artery Disease/blood/*therapy
MH  - Cytochrome P-450 CYP2C19
MH  - Drug Interactions
MH  - Drug Resistance
MH  - Female
MH  - Heptanoic Acids/*administration & dosage/adverse effects
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage/adverse 
      effects
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Pharmacogenetics
MH  - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects
MH  - Platelet Function Tests
MH  - Prospective Studies
MH  - Purinergic P2Y Receptor Antagonists/*administration & dosage/adverse effects
MH  - Pyrroles/*administration & dosage/adverse effects
MH  - Receptors, Purinergic P2Y12/blood/drug effects
MH  - Risk Assessment
MH  - Risk Factors
MH  - Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2013/02/23 06:00
MHDA- 2013/08/13 06:00
CRDT- 2013/02/23 06:00
PHST- 2012/05/24 00:00 [received]
PHST- 2012/08/30 00:00 [revised]
PHST- 2012/09/12 00:00 [accepted]
PHST- 2013/02/23 06:00 [entrez]
PHST- 2013/02/23 06:00 [pubmed]
PHST- 2013/08/13 06:00 [medline]
AID - S1936-8798(12)01172-7 [pii]
AID - 10.1016/j.jcin.2012.09.013 [doi]
PST - ppublish
SO  - JACC Cardiovasc Interv. 2013 Feb;6(2):169-79. doi: 10.1016/j.jcin.2012.09.013.