Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation: a systematic review and meta-analysis
Abstract Background Combination of statins and clopidogrel is frequently administered in patients with coronary artery disease (CAD). They are mainly activated and eliminated in the liver by cytochrome P450 isoenzyme 3A4 (CYP3A4). The aim was to clarify whether the coadministration of clopidogrel an...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | Lipids in Health and Disease |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12944-019-1053-0 |
| _version_ | 1811288909718487040 |
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| author | Ke An Rong Huang Sai Tian Dan Guo Jiaqi Wang Hongyan Lin Shaohua Wang |
| author_facet | Ke An Rong Huang Sai Tian Dan Guo Jiaqi Wang Hongyan Lin Shaohua Wang |
| author_sort | Ke An |
| collection | DOAJ |
| description | Abstract Background Combination of statins and clopidogrel is frequently administered in patients with coronary artery disease (CAD). They are mainly activated and eliminated in the liver by cytochrome P450 isoenzyme 3A4 (CYP3A4). The aim was to clarify whether the coadministration of clopidogrel and statins attenuate respective efficacy. Methods PubMed, Embase, the Cochrane Library, Web of Science and Clinical Trials. gov were searched for until August 2018. Randomized controlled trials (RCTs) and cohort studies were taken into quality evaluation. Data were pooled using random effect models to estimate standard mean difference (SMD) or risk ratio (RR) with 95% confidence interval (CI). Results In total, 28 studies representing 25,267 participants were included. Statins reduce the mortality of patients administered clopidogrel (RR 0.54; 95% CI 0.40,0.74; p = 0.000), no differences were found in platelet aggregation (PA) (SMD 0.02; 95% CI -0.38,0.42; p = 0.920) and the expressions of P-selectin (SMD -0.04; 95% CI -0.14,0.05; p = 0.346), CD40L (SMD 0.09; 95% CI -0.29,0.48; p = 0.633), CD63 (SMD 0.09; 95% CI -0.01,0.19; p = 0.079) and PAC-1 (SMD 0.03; 95% CI -0.08,0.13; p = 0.633). Furthermore, CYP3A4 metabolized or non-CYP3A4 metabolized statins have no discrepancies in PA (SMD 0.13; 95% CI -0.31,0.58; p = 0.556), P-selectin (SMD 0.17; 95% CI -0.16,0.51; p = 0310), death (RR 0.89; 95% CI 0.38,2.07; p = 0.791), except for triglyceride (TG) (SMD -0.19; 95% CI –0.33,-0.06; p = 0.005). Conclusions This meta-analysis confirmed that statins reduce mortality in patients undergoing clopidogrel treatment without affecting platelet activation and aggregation. |
| first_indexed | 2024-04-13T03:45:49Z |
| format | Article |
| id | doaj.art-6e414be5e0f94d0fa7cfc6ef12ce2f04 |
| institution | Directory Open Access Journal |
| issn | 1476-511X |
| language | English |
| last_indexed | 2024-04-13T03:45:49Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj.art-6e414be5e0f94d0fa7cfc6ef12ce2f042022-12-22T03:04:01ZengBMCLipids in Health and Disease1476-511X2019-05-0118111110.1186/s12944-019-1053-0Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation: a systematic review and meta-analysisKe An0Rong Huang1Sai Tian2Dan Guo3Jiaqi Wang4Hongyan Lin5Shaohua Wang6Department of Endocrinology, Affiliated Zhongda Hospital of Southeast UniversityDepartment of Endocrinology, Affiliated Zhongda Hospital of Southeast UniversityDepartment of Endocrinology, Affiliated Zhongda Hospital of Southeast UniversityDepartment of Endocrinology, Affiliated Zhongda Hospital of Southeast UniversityDepartment of Endocrinology, Affiliated Zhongda Hospital of Southeast UniversityDepartment of Endocrinology, Affiliated Zhongda Hospital of Southeast UniversityDepartment of Endocrinology, Affiliated Zhongda Hospital of Southeast UniversityAbstract Background Combination of statins and clopidogrel is frequently administered in patients with coronary artery disease (CAD). They are mainly activated and eliminated in the liver by cytochrome P450 isoenzyme 3A4 (CYP3A4). The aim was to clarify whether the coadministration of clopidogrel and statins attenuate respective efficacy. Methods PubMed, Embase, the Cochrane Library, Web of Science and Clinical Trials. gov were searched for until August 2018. Randomized controlled trials (RCTs) and cohort studies were taken into quality evaluation. Data were pooled using random effect models to estimate standard mean difference (SMD) or risk ratio (RR) with 95% confidence interval (CI). Results In total, 28 studies representing 25,267 participants were included. Statins reduce the mortality of patients administered clopidogrel (RR 0.54; 95% CI 0.40,0.74; p = 0.000), no differences were found in platelet aggregation (PA) (SMD 0.02; 95% CI -0.38,0.42; p = 0.920) and the expressions of P-selectin (SMD -0.04; 95% CI -0.14,0.05; p = 0.346), CD40L (SMD 0.09; 95% CI -0.29,0.48; p = 0.633), CD63 (SMD 0.09; 95% CI -0.01,0.19; p = 0.079) and PAC-1 (SMD 0.03; 95% CI -0.08,0.13; p = 0.633). Furthermore, CYP3A4 metabolized or non-CYP3A4 metabolized statins have no discrepancies in PA (SMD 0.13; 95% CI -0.31,0.58; p = 0.556), P-selectin (SMD 0.17; 95% CI -0.16,0.51; p = 0310), death (RR 0.89; 95% CI 0.38,2.07; p = 0.791), except for triglyceride (TG) (SMD -0.19; 95% CI –0.33,-0.06; p = 0.005). Conclusions This meta-analysis confirmed that statins reduce mortality in patients undergoing clopidogrel treatment without affecting platelet activation and aggregation.http://link.springer.com/article/10.1186/s12944-019-1053-0ClopidogrelStatinsMeta-analysisMortalityPlatelet aggregationLipid |
| spellingShingle | Ke An Rong Huang Sai Tian Dan Guo Jiaqi Wang Hongyan Lin Shaohua Wang Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation: a systematic review and meta-analysis Lipids in Health and Disease Clopidogrel Statins Meta-analysis Mortality Platelet aggregation Lipid |
| title | Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation: a systematic review and meta-analysis |
| title_full | Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation: a systematic review and meta-analysis |
| title_fullStr | Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation: a systematic review and meta-analysis |
| title_full_unstemmed | Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation: a systematic review and meta-analysis |
| title_short | Statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation: a systematic review and meta-analysis |
| title_sort | statins significantly reduce mortality in patients receiving clopidogrel without affecting platelet activation and aggregation a systematic review and meta analysis |
| topic | Clopidogrel Statins Meta-analysis Mortality Platelet aggregation Lipid |
| url | http://link.springer.com/article/10.1186/s12944-019-1053-0 |
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