Abstract:
Objective To evaluate the effects of different statins (CYP3A4 metabolized statins and CYP2C9 metabolized statins) combined with Clopidogrel on the platelet functions in patients with acute coronary syndrome (ACS) by meta analysis.
Method Both foreign and Chinese databases including PubMed, EMBASE, Cochrane library, and CNKI were searched to identify randomized controlled trials (RCTs) that reported the effects of different statins combined with Clopidogrel on the platelet functions and major adverse cardiac events (MACE). Two reviews assessed the quality of each trial and extracted data independently. The Cochrane Collaboration’s RevMan 4.2.8 software was used for statistical analysis.
Results A total of 11 RCTs were included, and the methodological quality of each trial was good. There was no significant difference in platelet aggregation rate when different types of statins were used(WMD=0.39, 95%CI -1.84~2.62,
P=0.73), as well as the incidence of MACE(OR=1.07, 95%CI 0.77~1.49,
P=0.69). However, the level of P-selectin was lower in patients received CYP3A4 metabolized statins (WMD=-1.16, 95%CI -1.77 ~ -0.54,
P=0.000 2).
Conclusion Both statins metabolized with and without CYP3A4 were safe for ACS patients.