Atorvastatin Does Not Alter the Anticoagulant Activity of Warfarin

Stern, Robert L.; Abel, Robert; Gibson, Gordon L.; Besserer, Judith

doi:10.1002/j.1552-4604.1997.tb04288.x

Cited by 44 publications

(25 citation statements)

References 5 publications

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“…The lack of clinically significant pharmacological interaction between vitamin K antagonists and atorvastatin/ezetimibe has also been demonstrated in previous smaller studies performed in healthy people. 30,31 Oral anticoagulation has been reported to produce a 67% risk reduction in thromboembolic stroke in AF patients compared with placebo 8 with a 36% greater reduction in ischemic stroke reduction than aspirin, 32 despite a 1 %/year risk for severe bleeding. 8 The SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) trial 33 showed a significant decrease in ischemic stroke rate, when patients with previous ischemic stroke and sinus rhythm were given intensive cholesterol-lowering therapy with atorvastatin 80 mg on top of antiplatelet treatment with aspirin.…”

Section: Discussionmentioning

confidence: 98%

Persisting thrombin activity in elderly patients with atrial fibrillation on oral anticoagulation is decreased by anti-inflammatory therapy with intensive cholesterol-lowering treatment

Kuilenburg

Lappegård

Sexton

et al. 2011

Journal of Clinical Lipidology

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Section: Discussionmentioning

confidence: 98%

Persisting thrombin activity in elderly patients with atrial fibrillation on oral anticoagulation is decreased by anti-inflammatory therapy with intensive cholesterol-lowering treatment

Kuilenburg

Lappegård

Sexton

et al. 2011

Journal of Clinical Lipidology

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“…24,25 This effect has, for example, been observed in patients treated with simvastatin, but not in patients using atorvastatin. 26 Nevertheless, the SPARCL study, which randomized patients to atorvastatin, showed an increased occurrence of hemorrhagic stroke. Thus, interactions between statins and anticoagulant drugs probably do not account for the increased occurrence of hemorrhagic stroke in this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Statin Treatment and the Occurrence of Hemorrhagic Stroke in Patients With a History of Cerebrovascular Disease

Vergouwen

Haan

Vermeulen

et al. 2008

Stroke

160

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Background and Purpose-The recently published Stroke Prevention by Aggressive Reduction in Cholesterol Levels(SPARCL) study showed that statins exert a marginally beneficial effect on stroke prevention in patients with a history of cerebrovascular disease. Interestingly, the magnitude of the beneficial effect shown in this study is smaller than in similar studies, which included patients without a history of cerebrovascular disease. In SPARCL, an increased occurrence of hemorrhagic strokes in patients on statin treatment was observed, an effect that was also earlier described in the Heart Protection Study in a subgroup of patients with a history of cerebrovascular disease. The purpose of this systematic review was therefore to investigate the effect of statin treatment on the occurrence of ischemic and hemorrhagic strokes in patients with a history of cerebrovascular disease. Methods-We systematically searched the PUBMED database for the combination of the variables "statin" AND "stroke."Furthermore

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“…Co-administration of warfarin and pravastatin had no effect on the bioavailability of pravastatin, but did increase the plasma concentration of warfarin [63], therefore, warfarin dose should be monitored. By contrast, a lack of interaction between atorvastatin and warfarin suggests there is no need for adjusting warfarin dose when used in combination with atorvastatin [67].…”

Section: Combination Therapymentioning

confidence: 94%

Pharmacotherapy of hypercholesterolaemia: statins in clinical practice

2000

Expert Opinion on Pharmacotherapy

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The objective of this article is to evaluate the roles of the lipid-lowering class of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) in reducing cardiovascular events and to review their mechanism of action based on in vitro and in vivo studies. The clinical outcome of 15 major clinical trials has been critically reviewed and summarised; all showed a high degree of efficacy and safety. Statins, either in active or prodrug forms, are potent inhibitors of HMG-CoA reductase, have good absorption rate and their bioavailability depends on their lipophobicity and concomitant use with meals. Abdominal discomfort is the most commonly reported adverse effect. Although the incidence is low, myopathy with or without rhabdomyolysis may be considered a serious adverse effect of statins. A combination of a statin with gemfibrozil seems to increase the risk of this adverse event, particularly in patients with renal impairment. Combination therapy with several other agents, frequently administered to cardiovascular patients, has also been reviewed. Statin therapy is considered highly cost effective in secondary prevention, but it is less cost effective in primary prevention. This factor may underline the rationale for developing other safe and effective agents with an improved cost effectiveness profile. The pleiotropic non-lipid lowering effects of statins may include their anti-oxidant and antithrombotic potential as well as restoration of endothelial function. Statins may also be beneficial in the treatment of osteoporosis. Fewer studies have investigated statins' effects on the quality of lipoprotein particles, the activities of cholesteryl ester transfer protein and lecithin:cholesterol acyltransferase as well as their possible synergistic effects with n-3 fatty acids, anti-oxidants and aspirin in reducing cardiovascular events.

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Atorvastatin Does Not Alter the Anticoagulant Activity of Warfarin

Cited by 44 publications

References 5 publications

Persisting thrombin activity in elderly patients with atrial fibrillation on oral anticoagulation is decreased by anti-inflammatory therapy with intensive cholesterol-lowering treatment

Persisting thrombin activity in elderly patients with atrial fibrillation on oral anticoagulation is decreased by anti-inflammatory therapy with intensive cholesterol-lowering treatment

Statin Treatment and the Occurrence of Hemorrhagic Stroke in Patients With a History of Cerebrovascular Disease

Pharmacotherapy of hypercholesterolaemia: statins in clinical practice

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