RESUMO
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. The goal of this study was to investigate whether the co-administration of atorvastatin could aggravate the hepatic - toxicity of clopidogrel. 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. 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. Combination of atorvastatin and clopidogrel may induce hepatic injury cholestatic type resulting from abnormal bile flow caused by either drugs or its metabolites