Korean J Clin Pharm.  2019 Dec;29(4):254-266. 10.24304/kjcp.2019.29.4.254.

Clinical Outcomes of Antiplatelets Combined with Statins in Patients with Ischemic Heart Disease

• Kim C
• Lee J
• Park RW
• Lee S

• KMID: 2470463
• DOI: http://doi.org/10.24304/kjcp.2019.29.4.254

Abstract

BACKGROUND
Patients with cardiovascular risks are recommended to use statins and antiplatelet agents to prevent major cerebrocardiovascular events (MACCE). Antiplatelet agents also possess anti-inflammatory and antioxidant effects, in addition to their inhibitory activity on platelets. The differences in clinical outcomes in ischemic heart disease (IHD) based on the type of antiplatelet therapy combined with statin treatment were investigated in this study.
METHODS
We conducted a retrospective cohort study using electronic medical records of IHD patients from January 2010 to December 2014 at Ajou University Hospital. Patients on combination therapy of antiplatelet drugs and statins were grouped based on antiplatelet drug types: clopidogrel, cilostazol, or sarpogrelate. Propensity score matching was applied to balance the baseline of the groups of clopidogrel vs. cilostazol and the groups of clopidogrel vs. sarpogrelate. The incidence and risk of MACCE as primary outcomes were assessed between the groups of antiplatelet drugs.
RESULTS
Among the approximately 128,500 patients with IHD, 1,049 patients had taken a combination therapy of statin and antiplatelet agents. The cohorts of patients administered clopidogrel, cilostazol, or sarpogrelate were 906, 79, and 64, respectively. The incidence of MACCE was not significantly different among the cohorts (p=0.58), and there were no differences between clopidogrel vs. cilostazol (p=0.72) or clopidogrel vs. sarpogrelate (p=1.00) after propensity score matching.
CONCLUSION
There was no difference in the incidence of MACCE based on the type of antiplatelet drug (clopidogrel, cilostazol, or sarpogrelate) in combination with a statin in patients with IHD.

Keyword

Major adverse cerebro-cardiovascular events (MACCE); statin; clopidogrel; cilostazol; sarpogrelate; real world data

MeSH Terms

Antioxidants
Cohort Studies
Electronic Health Records
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors*
Incidence
Myocardial Ischemia*
Platelet Aggregation Inhibitors
Propensity Score
Retrospective Studies
Antioxidants
Platelet Aggregation Inhibitors