The efficacy and safety of clopidogrel and aspirin in coronary heart disease with angina pectoris: a systematic review and meta-analysis

摘要

Background:To assess the efficacy and safety of clopidogrel combined with aspirin for angina pectoris.Methods:Randomized controlled trials were searched in PubMed,Excerpta Medica Database,the Cochrane Library,China National Knowledge Infrastructure,WANFANG databases and VIP databases from inception to February,2020.Methodological quality was evaluated by the tool of Cochrane collaboration.The meta-analysis was performed in the RevMan 5.3.Results:Fourteen randomized controlled trials with a total of 1,130 participants were included.Meta-analysis showed that for patients with angina pectoris,clopidogrel combined with aspirin had better clinical efficacy than aspirin alone(RR=1.26,95%CI:1.19-1.32,P<0.00001);on the interval time,duration and frequency of angina attack,clopidogrel and aspirin had better effect than aspirin alone(MD=2.09,95%CI:2.07-2.11,P<0.00001;MD=−2.48,95%CI:−3.12 to−1.84,P<0.00001;MD=−1.47,95%CI:−2.59 to−0.35,P=0.01,respectively).Moreover,the available data showed that aspirin and clopidogrel for patients with coronary heart disease with angina pectoris were safer than aspirin alone(RR=0.41,95%CI:0.27-0.61,P<0.0001).Conclusion:Clopidogrel combined with aspirin could be effective for patients with angina pectoris,meanwhile,it is important to be aware of the potential side effects.