{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:46:40Z","timestamp":1760028400489,"version":"3.37.0"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,3,2]],"date-time":"2009-03-02T00:00:00Z","timestamp":1235952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Clopidogrel is an antiplatelet drug that is prescribed after percutaneous coronary intervention (PCI) to prevent stent thrombosis. Previous studies have suggested that some statins may inhibit the antiplatelet effects of clopidogrel<jats:italic>via<\/jats:italic>competitive metabolism of its activating enzyme cytochrome P450 3A4 (CYP3A4).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate a possible interaction between statins and clopidogrel after a PCI procedure in a population\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A population\u2010based cohort study was carried out between January 2001 and December 2004 using the health insurance databases from Quebec, Canada. The primary endpoint was a composite of death from any cause, myocardial infarction (MI), unstable angina, repeat revascularization and cerebrovascular events. PCI patients\u2009\u2265\u200966 years of age were followed from their initial post\u2010discharge clopidogrel prescription until the earliest of study endpoint occurrence, end of clopidogrel exposure or end of study (90 days post discharge). Time\u2010dependent Cox regression analysis was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 10\u2009491 patients who were prescribed clopidogrel post\u2010PCI and 43.5% were also prescribed statins at the baseline discharge. During 1793 patient years of follow\u2010up, 623 composite endpoints were observed. Compared to the reference group (non\u2010CYP3A4\u2010metabolized statins), the co\u2010prescription of CYP3A4\u2010metabolized statins (hazard ratio (HR) 1.16, 95% confidence interval (CI) 0.91\u20131.47), or no statin use (HR 1.22, 95%CI 0.93\u20131.59) were not statistically associated with an increase in adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this PCI cohort, the association of clopidogrel with CYP3A4\u2010metabolized statins did not demonstrate an increased early risk of adverse cardiovascular events, although a small risk could not be completely excluded. Copyright \u00a9 2009 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.1716","type":"journal-article","created":{"date-parts":[[2009,3,2]],"date-time":"2009-03-02T13:53:21Z","timestamp":1236002001000},"page":"362-369","source":"Crossref","is-referenced-by-count":18,"title":["Investigation of an interaction between statins and clopidogrel after percutaneous coronary intervention: a cohort study"],"prefix":"10.1002","volume":"18","author":[{"given":"Ana","family":"Blagojevic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A.C.","family":"Delaney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda E.","family":"L\u00e9vesque","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nandini","family":"Dendukuri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Francois","family":"Boivin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M.","family":"Brophy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,3,2]]},"reference":[{"key":"e_1_2_1_2_2","unstructured":"WHO. 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