Background: Limitations have been observed with the use of clopidogrel following percutaneous coronary intervention (PCI) indicating the urgent need of a more potent anti-platelet agent. We aimed to compare the efficacy and safety of ticagrelor versus clopidogrel following PCI.
Methods: Online databases were searched for relevant studies (published between the years 2007 and 2017) comparing ticagrelor versus clopidogrel following coronary stenting. Primary outcomes assessed efficacy whereas secondary outcomes assessed safety. Odds ratios (OR) with 95% confidence intervals (CIs) based on a random effect model were calculated and the analysis was carried out by the RevMan 5.3 software.
Results: A total number of 25,632 patients with acute coronary syndrome (ACS) [12,992 patients with ST segment elevation myocardial infarction (STEMI) and 14,215 patients with non-ST segment elevation myocardial infarction (NSTEMI)] were included in this analysis, of whom 23,714 patients were revascularized by PCI. Results of this analysis did not show any significant difference in all-cause mortality, major adverse cardiac events (MACEs), myocardial infarction, stroke and stent thrombosis observed between ticagrelor and clopidogrel with (OR: 0.83, 95% CI: 0.67-1.03; P = .09), (OR: 0.64, 95% CI: 0.41-1.01; P = .06), (OR: 0.77, 95% CI: 0.57-1.03; P = .08), (OR: 0.85, 95% CI: 0.57-1.26; P = .42) and (OR: 0.70, 95% CI: 0.47-1.05; P =.09).However, ticagrelor was associated with a significantly higher minor and major bleeding with (OR: 1.57, 95% CI: 1.30-1.89; P = .00001) and (OR: 1.52, 95% CI: 1.01-2.29; P = 0.04) respectively. Dyspnea was also significantly higher in the ticagrelor group (OR: 2.64, 95% CI: 1.87-3.72; P = .00001).
Conclusion: Ticagrelor and clopidogrel were comparable in terms of efficacy in these patients with ACS. However, the safety outcomes of ticagrelor should further be investigated.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221558 | PMC |
http://dx.doi.org/10.1097/MD.0000000000012978 | DOI Listing |
Coron Artery Dis
January 2025
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China.
Background: It is uncertain whether ticagrelor is more effective and safer than clopidogrel in ST-segment elevation myocardial infarction (STEMI) patients in the East Asian population in the real world. This study compared the clinical outcomes of ticagrelor and clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention (PCI).
Methods: We retrospectively enrolled 1124 patients diagnosed with STEMI in Nanjing First Hospital from July 2011 to April 2019.
Int Heart J
January 2025
Department of Cardiology, The First Affiliated Hospital of Dali University.
Ticagrelor, an effective antiplatelet for acute coronary syndrome (ACS), may elevate serum uric acid (SUA), potentially causing gout. This study aims to identify risk factors for ticagrelor-induced in-hospital gout in patients with ACS and create a predictive model for clinical use.A total of 1164 patients with ACS treated with ticagrelor (n = 640) or clopidogrel (n = 524) were retrospectively analyzed.
View Article and Find Full Text PDFJ Clin Exp Dent
December 2024
Unit of Oral Basic Investigation, UIBO School of Dentistry, Universidad El Bosque, Bogota, Colombia.
Background: This study aimed to compare the incidence of bleeding using two periodontal treatment protocols in patients with recent Acute Coronary Syndrome (ACS).
Material And Methods: This is an interim analysis of a double-blind controlled clinical trial evaluating two periodontal treatment schemes in patients with recent ACS treated with different dual antiplatelet regimens: Clopidogrel+ASA, Prasugrel+ASA and Ticagrelor+ASA. After randomisation six patients (22 quadrants) were treated with Scheme A (scaling and root planning-SRP) and six patients (21 quadrants) with Scheme B (ultrasonic scaling-US).
J Interv Card Electrophysiol
January 2025
Heart Center, Department of Cardiology, Amsterdam Cardiovascular Sciences Heart Failure & Arrhythmias, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
Background: Little data exists regarding the optimal antithrombotic strategy during S-ICD implantation to prevent pocket hematomas. This study explores the association between perioperative antithrombotic management and the occurrence of pocket hematoma following S-ICD implantation.
Methods: All patients who underwent de novo S-ICD implantation between February 2009 and January 2023 at Amsterdam UMC were included.
Acta Cardiol Sin
January 2025
Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University.
Background: Dual antiplatelet therapy (DAPT) is the standard treatment for acute myocardial infarction (MI). This study aimed to investigate the use of DAPT and de-escalation after discharge in real-world practice among patients with acute MI undergoing percutaneous coronary intervention (PCI) in Taiwan.
Methods: Using the Taiwan National Health Insurance Research Database, we included patients who received PCI for acute MI and survived to discharge with DAPT from 2011 to 2021.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!