Objective  To investigate the efficacy and safety of clopidogrel and tigrillo in treating elderly acute coronary syndrome (ACS) patients with hepatic injury caused by statins.

  Methods  Totally 160 elderly patients with ACS were randomly divided into control group and observation group, with 80 cases in each group. The control group was treated with clopidogrel, while the observation group was treated with tigrillo. The platelet aggregation rates at 3, 7 and 30 days after medication, the occurrence of cardiovascular and cerebrovascular adverse events (recurrent angina pectoris, heart failure, myocardial infarction, stroke) and the safety of medication (major bleeding events, minor bleeding events, dyspnea and creatinine elevation) were observed in both groups.

  Results  The platelet aggregation rates at 3, 7 and 30 days after medication in the observation group were significantly lower than those in the control group (P < 0.05). The incidence rate of cardiovascular and cerebrovascular events in the control group was significantly higher than that in the observation group (P < 0.05). There were no major bleeding events in both groups. The number of patients with secondary bleeding events in the observation group was more than that in the control group, but there was no significant difference (P>0.05). The incidence rate of dyspnea in the observation group was higher than that in the control group at 2 months of follow-up, but then decreased significantly. There was no increase of creatinine in both groups.

  Conclusion  Tigrillo is safe in the treatment of elderly ACS patients with statin-induced liver dysfunction. No major bleeding events and dyspnea symptoms occur in the patients, and theincidence rate of cardiovascular and cerebrovascular events is low.