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The investigators team had found that the presence of dynamic changes of Clopidogrel resistance are not associated with genetic factors. Currently, study on moderate doses of statins and dynamic Clopidogrel resistance has not been reported, therefore this study will observe 160 cases of open prospective secondary prevention in patients with cerebral infarction. Excluded: those patients occurs Clopidogrel resistance because of slow metabolism caused by cytochrome P450 isoenzyme 2C19(CYP2C19, and then observed the impact of the cytochrome P450 isoenzyme 3A4 (CYP3A4)-metabolized and non-cytochrome P450 isoenzyme 3A4 (CYP3A4)-metabolized statins dynamically on Clopidogrel resistance in the next 9 months, adverse events will be recorded, the metabolite of clopidogrel(H4 )and the polymorphism of cytochrome P450 isoenzyme 2C19 (CYP2C19)/cytochrome P450 isoenzyme 3A4 (CYP3A4)/ cytochrome P450 isoenzyme 2C9(CYP2C9)will be detected. Expected Result: the patients use the cytochrome P450 isoenzyme 3A4(CYP3A4)-metabolized statins will result in dynamic Clopidogrel resistance easily ,H4 levels will decline, and Clopidogrel resistance is not related to the polymorphism of cytochrome P450 isoenzyme 3A4 (CYP3A4).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| atorvastatin and Clopidogrel | Active Comparator | 80 patients will be taking atorvastatin 40mg/d plus clopidogrel 75mg/d for 9 months。 |
|
| rosuvastatin and Clopidogrel | Experimental | 80 patients will be taking rosuvastatin 20mg/d plus clopidogrel 75mg/d for 9 months。 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| atorvastatin and clopidogrel | Drug | Dose: atorvastatin 40mg/d plus clopidogrel 75mg/d for 9 months. |
|
| Measure | Description | Time Frame |
|---|---|---|
| incidence of clopidogrel resistance | Definition of clopidogrel resistance is the absolute change of 5 microliter adenosine diphosphate(ADP) induced PAR≤10% as compared to baseline. So, incidence of clopidogrel resistance= (PAR at monitor point - PAR at baseline) / PAR at baseline×100 %≤10 %。 Measures of PAR: PAR is measured by Light transmittance aggregometry (LTA) and according to the standard of Rev。 | For nine months |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19829090 | Result | Sugunaraj JP, Palaniswamy C, Selvaraj DR, Chaitanya Arudra SK, Sukhija R. Clopidogrel resistance. Am J Ther. 2010 Mar-Apr;17(2):210-5. doi: 10.1097/MJT.0b013e3181bdc3e4. | |
| 15837243 | Result | Nguyen TA, Diodati JG, Pharand C. Resistance to clopidogrel: a review of the evidence. J Am Coll Cardiol. 2005 Apr 19;45(8):1157-64. doi: 10.1016/j.jacc.2005.01.034. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Mar 9, 2018 | |
| Unrelease | Yes | |
| Release | Apr 28, 2018 |
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| rosuvastatin and clopidogrel | Drug | Dose: rosuvastatin 20mg/d plus clopidogrel 75mg/d for 9 months. |
|
| 16386660 | Result | Lev EI, Patel RT, Maresh KJ, Guthikonda S, Granada J, DeLao T, Bray PF, Kleiman NS. Aspirin and clopidogrel drug response in patients undergoing percutaneous coronary intervention: the role of dual drug resistance. J Am Coll Cardiol. 2006 Jan 3;47(1):27-33. doi: 10.1016/j.jacc.2005.08.058. Epub 2005 Dec 9. |
| Unrelease | Yes |
| Release | May 2, 2018 |
| Reset | Jun 1, 2018 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Mar 9, 2018 | Yes | |||
| Apr 28, 2018 | Yes | |||
| May 2, 2018 | Jun 1, 2018 |
| ID | Term |
|---|---|
| D002544 | Cerebral Infarction |
| ID | Term |
|---|---|
| D020520 | Brain Infarction |
| D002545 | Brain Ischemia |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020521 | Stroke |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |
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| ID | Term |
|---|---|
| D000069059 | Atorvastatin |
| D000077144 | Clopidogrel |
| D000068718 | Rosuvastatin Calcium |
| ID | Term |
|---|---|
| D011758 | Pyrroles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D006538 | Heptanoic Acids |
| D005227 | Fatty Acids |
| D008055 | Lipids |
| D013988 | Ticlopidine |
| D058924 | Thienopyridines |
| D013876 | Thiophenes |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D011725 | Pyridines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D013449 | Sulfonamides |
| D000577 | Amides |
| D005464 | Fluorobenzenes |
| D006845 | Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D013450 | Sulfones |
| D011743 | Pyrimidines |
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