Objective To investigate clinical effects of clopidogrel combined with simvastatin or fluvastatin on the platelet aggregation rate (PAR), platelet activation marker CD62P and the incidence of major adverse cardiovascular events (MACE) in patients with ACS.
Methods From April 2008 to December 2009, one hundred patients (79 male and 21 female, average age 61.46±12.84 years) who had been diagnosed as ACS were enrolled into this study. These cases were randomly divided into two groups, the Group A (n=50, treated with simvastatin 20 mg per night); the Group B (n=50, treated with fluvastatin 40 mg per night). Detailed clinical information was collected. PAR, CD62P, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) of the two groups were measured. All cases received clopidogrel (a loading dose of 300 mg and then 75 mg daily), aspirin and Low molecular weight heparin. The MACE within 14 days were recorded.
Result there was no significant differences in baseline between the Group A and Group B. There was no significant differences in the PAR and expression rate of CD62P after 300 mg clopidogrel (p>0.05). 1h after treated with statins the expression rate of CD62P and PAR in the two groups were lower than that before treated with statins (p<0.05). After 14d treated with statins the expression rate of CD62P and PAR were still lower than that before treated with statins (p<0.05). There were no significant increase of ALT and AST in the both groups (p>0.05). After the above-mentioned medical treatment, the expression rate of CD62P and PAR in the two groups were similar (p>0.05). There were no significant differences in the incidence of MACE between two groups.
Conclusion ACS patients with loading dose clopidogrel combined with simvastatin or fluvastatin could decrease the MACE, the results in two groups are similar. Neither simvastatin with clopidogrel nor fluvastatin with clopidogrel decreases the platelet activity of clopidogrel.