Clopidogrel and statin reload protects against early cerebral ischemic events

Clopidogrel and statin reload protects against early cerebral ischemic events

Clopidogrel and statin reload: ARMYA-9 CAROTID study [1] has concluded that a loading dose of 600 mg of clopidogrel and high dose atorvastatin in those undergoing carotid stenting protects against early ischemic cerebral events. The study involved over one hundred and fifty patients who underwent protected carotid stenting. Clopidogrel loading was either 600 or 300 mg given six hours prior to the procedure. Eighty milligrams of atorvastatin was given 12 hours prior to the procedure and forty milligrams about two hours before the procedure. The control arm received no statin reload. All were on long term statin therapy. The primary end points were the incidence of transient ischemic attack / stroke at thirty days or new ischemic lesions noted on diffusion weighted magnetic resonance imaging of the brain in one two days. Primary end points were lower in the 600 mg clopidogrel arm (18% vs 35.9%) as well as in the atorvastatin reload arm (18.4% vs 35%).

Reference

1. Giuseppe Patti, Fabrizio Tomai, Rosetta Melfi, Elisabetta Ricottini, Michele Macrì, Pietro Sedati, Arianna Giardina, Cristina Aurigemma, Mario Leporace, Andrea D’Ambrosio, Germano Di Sciascio. Strategies of Clopidogrel Load and Atorvastatin Reload to Prevent Ischemic Cerebral Events in Patients Undergoing Protected Carotid Stenting: Results of the Randomized ARMYDA-9 CAROTID (Clopidogrel and Atorvastatin Treatment During Carotid Artery Stenting) Study. J Am Coll Cardiol. 2013 Apr 2;61(13):1379-87.