Efficacy and Safety of Atorvastatin and Amlodipine in the Treatment of Cardia-cerebral Disease: a Systematic Review and Meta-analysis of Randomized Controlled Trials

Wang Yang; Liu Guanghui; Zhang Zhe; Zhang Fan; Kong Dezhao; Yang Guanlin

doi:10.3969/j.issn.1672-1349.2018.01.003

Abstract：Objective To systematically evaluate the efficacy and safety of atorvastatin and amlodipine in the treatment of cardia-cerebral disease.Methods China National Knowledge Infrastructure Database (CNKI),Wangfang Database,Chongqing VIP Database (VIP),China Biology Medicine Database (CBM),Medline (PubMed),and Cochrane Library were retrieved with the deadline on January 6,2017.The inclusion trials of AP complicated with cardia-cerebral disease were atorvastatin and amlodipine plus conventional treatment or amlodipine plus conventional treatment.The risk of bias of cochrane handbook and RevMan 5.3 were conducted by authors.Sensitivity analysis was constructed by using two different effect models.Besides,a funnel plot was created to analyze potential publication bias.Results One thousands,three hundreds and fifty-eight patients from thirteen studies were included,and the quality of methodology was low.As for atorvastatin and amlodipine plus conventional treatment to amlodipine plus conventional treatment,the relative risk (RR) and 95％ confidence interval (CI) of improvement of clinical symptoms was 1.25 [1.18,1.32],respectively,and the mean difference (MD) and 95％ CI of cholesterol total,triglyceride and the European Stroke Scale scores were-0.36 [-0.50,-022],-0.37 [-0.49,-0.25] and 14.29 [11.45,17.13].Eight studies of low-density lipoprotein showed that the experimental group was obviously superior to the control group.As for atorvastatin and amlodipine plus conventional treatment to conventional treatment,RR and 95％ CI of improvement of clinical symptoms was 1.26 [1.09,1.46],respectively,and MD and 95％ CI of high-density lipoprotein,lactate dehydrogenase and the European Stroke Scale Scores were 0.51 [0.41,0.62],-12.62 [-13.81,-11.43] and 11.90 [8.31,15.50].Three studies of cholesterol total、low-density lipoprotein and creatine kinase MB showed that the experimental group was obviously superior to the control group.Eight studies have made no mention of adverse reaction and five studies of adverse reactions were described.Conclusion Atorvastatin and amlodipine may improve the blood lipid levels,lower the levels of serum myocardial enzyme,enhance the European Stroke Scale,release clinical syndromes in patients with AP complicated with cardia-cerebral disease.