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Hepatotoxicity of Combined Therapy of Atorvastatin with Platelet P2Y12-ADP Receptor Antagonist in Coronary Heart Disease Treated Patients

    Feryal Hashim Rada Najat Abdulrazzaq Hasan Mohammed Hasan Al Baghdadi

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 1, Pages 108-113

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Abstract

ABSTRACT :
BACKGROUND:
Clopidogrel, an adenosine diphosphate receptor blocker, is widely used as an adjunctive antiplatelet therapy in coronary disease and percutaneous coronary stenting. It appears to be a safe drug with few occurrences of liver side-effects that usually resolved after drug withdrawal.
OBJECTIVE:
The goal of this study was to investigate whether the co-administration of atorvastatin could aggravate the hepatic - toxicity of clopidogrel.
PATIENTS AND METHODS:
Eighty patients with coronary disease were included in this study. All patients received a dose of 75 mg/day of clopidogrel. Forty patients group A with recent treatment (˂ 3 months) of clopidogrel; other forty patients group B with (˃ 1 year) treatment of clopidogrel. Liver function tests were measured and studied at baseline (clopidogrel without atorvastatin) and at 2, 4, 6 weeks of clopidogrel with atorvastatin (40 mg/day) afterwards.
RESULTS:
Liver function tests with co-therapy showed high significant elevation in mean serum total alkaline phosphatase (P˂0.001), significant decrease (P˂ 0.05) in mean serum gamma-glutamyl transferase ,significant elevation (P˂ 0.05) in mean serum direct bilirubin and insignificant elevation (P˃0.05) in mean serum total bilirubin , whereas the results appeared within normal range in mean serum levels of alanine aminotransferase, aspartate aminotransferase ,glutamate dehydrogenase -1,and total protein .
CONCLUSION:
Combination of atorvastatin and clopidogrel may induce hepatic injury cholestatic type resulting from abnormal bile flow caused by either drugs or its metabolites.
KEYWORDS: clopidogrel; atorvastatin; liver function tests.
Keywords:
    KEYWORDS Atorvastatin liver function tests
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(2015). Hepatotoxicity of Combined Therapy of Atorvastatin with Platelet P2Y12-ADP Receptor Antagonist in Coronary Heart Disease Treated Patients. Iraqi Postgraduate Medical Journal, 14(1), 108-113.
Feryal Hashim Rada; Najat Abdulrazzaq Hasan; Mohammed Hasan Al Baghdadi. "Hepatotoxicity of Combined Therapy of Atorvastatin with Platelet P2Y12-ADP Receptor Antagonist in Coronary Heart Disease Treated Patients". Iraqi Postgraduate Medical Journal, 14, 1, 2015, 108-113.
(2015). 'Hepatotoxicity of Combined Therapy of Atorvastatin with Platelet P2Y12-ADP Receptor Antagonist in Coronary Heart Disease Treated Patients', Iraqi Postgraduate Medical Journal, 14(1), pp. 108-113.
Hepatotoxicity of Combined Therapy of Atorvastatin with Platelet P2Y12-ADP Receptor Antagonist in Coronary Heart Disease Treated Patients. Iraqi Postgraduate Medical Journal, 2015; 14(1): 108-113.
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