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ǥ : ȣ - 530872   14 
Concomitant statin and calcium-channel blockers therapy dose not affect to clinical outcomes after percutaneous coronary intervention : Impact of dual competitive inhibition of CYP450 isoenzyme on clopidogrel metabolism
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윤성규, 승기배, 서석민, 추은호, 엄재선, 김지희, 고윤석, 정우백, 박만원, 최민석, 박훈준, 김범준, 장기육, 오용석, 정욱성, 김재형
Background Clopidogrel is activated by CYP450, which also metabolizes CCBs of the dihydropyridine class and lipophilic statin. Therefore, lipophilic statin and CCB may inhibite the CYP450 enzyme respectively and decrease the formation of the active metabolite of clopidogrel. but, impact on concomitant statin and calcium-channel blockers therapy related to effect of clopidogrel after index PCI have not been studied. Objectives We examined impact on concomitant statin and calcium-channel blockers therapy related to effect of clopidogrel after index PCI Methods A total 343 lesions in 160 patients with coronary artery disease undergoing percutaneous coronary intervention were retrospectively enrolled and divided to two groups ( lipophilic(atorvastatin) vs hydrophilic(rosuvastatin) statin-CCB ) We evaluated the occurrence of binary restenosis and clinical events (death from cardiovascular causes, stent thrombosis, nonfatal myocardial infarction and revascularization ) Results In atorvastain group, higher BMI( 24.9±2.9vs 23.9 ± 3.1, p=0.012), higher serum creatinine( 2.78±5.64 vs 1.7 ±2.1,p= 0.045), higher number of significant stenotic vessel (>50%) ( 2.3±0.7, 2.0 ±0.8, p=0.003) and smaller reference diameter ( 3.26±0.4 vs 3.37 ±0.4, p=0.045) were shown. Also, in rosuvastatin group, higher incidence of Pre-CABG history ( 0% vs 8.6%, p=0.001) and concomitant use of Nitrate (18% vs 69.8%, p <0.001) were showed. However, the rate of target lesion revascularization( 9.4% vs 8%, p=0.68) and binary restenosis( 15% vs 9.7%, p=0.22) did not differ in both groups. Conclusions Concomitant lipophilic statin - calcium channel blockers therapy dose not affect to clinical outcomes after percutaneous coronary intervention.


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