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Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and

Ke An1,2, Rong Huang1, Sai Tian1

  • 1Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87 DingJiaQiao Road, Nanjing, 210009, People's Republic of China.

Lipids in Health and Disease
|May 25, 2019
PubMed

Insights

Statins reduce mortality in patients taking clopidogrel without impacting platelet activation or aggregation. This combination therapy is safe and effective for coronary artery disease patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Coronary artery disease (CAD) patients frequently receive combination therapy with statins and clopidogrel.
  • Both medications are primarily metabolized by cytochrome P450 isoenzyme 3A4 (CYP3A4) in the liver.
  • Potential drug interactions affecting efficacy necessitate investigation.

Purpose of the Study:

  • To evaluate the impact of co-administering statins with clopidogrel on their respective efficacies.
  • To determine if statins influence clopidogrel's antiplatelet effects or patient mortality.

Main Methods:

  • A systematic search of major databases (PubMed, Embase, Cochrane, Web of Science) and ClinicalTrials.gov was conducted.
  • Included studies comprised randomized controlled trials (RCTs) and cohort studies, assessed for quality.
  • Data were pooled using random-effects models to calculate standard mean differences (SMD) and risk ratios (RR) with 95% confidence intervals (CI).

Main Results:

  • Twenty-eight studies with 25,267 participants were analyzed.
  • Statins significantly reduced mortality in patients on clopidogrel (RR 0.54; 95% CI 0.40-0.74).
  • No significant differences were observed in platelet aggregation, P-selectin, CD40L, CD63, or PAC-1 expression. Triglyceride levels were affected by statin metabolism type.

Conclusions:

  • Combination therapy of statins and clopidogrel is confirmed to reduce mortality in CAD patients.
  • Statins do not adversely affect clopidogrel's antiplatelet activation or aggregation properties.
  • The findings support the continued use of this combination therapy for cardiovascular risk reduction.
Abstract

Keywords:
ClopidogrelLipidMeta-analysisMortalityPlatelet aggregationStatins

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