Efficacy and Safety Profile of Ticagrelor Versus Clopidogrel in Percutaneous Coronary Intervention (PCI) for Acute Coronary Syndrome (ACS): A Systematic Review and Meta-Analysis

The utilization of individualized anti-platelet therapy is of paramount significance in this era of cardiovascular advancement. This meta-analysis is also aiming to get more information relating to the effectiveness of ticagrelor versus clopidogrel among patients undergoing percutaneous coronary int...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-10, Vol.15 (10), p.e46455-e46455
Main Authors: Maqbool, Shahzaib, Ali, Muhammad Sajjad, Rehman, Abdur, Ur Rehman, Mohammad Ebad, Iqbal, Javed, Razzaq, Azeen, Kamal, Amer, Shivamadhu, Shivani Shivamadhu, Afzal, Maham, Fazal, Faizan, Basit, Jawad, Khalid, Syed Aizaz
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Angioplasty
Asian people
Cardiology
Chi-square test
Cohort analysis
Confidence intervals
Drug dosages
Heart attacks
Internal Medicine
Medical Education
Metabolism
Mortality
Observational studies
Population
Stroke
Systematic review
Thrombosis
Variables
Citations: Items that this one cites
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Summary:The utilization of individualized anti-platelet therapy is of paramount significance in this era of cardiovascular advancement. This meta-analysis is also aiming to get more information relating to the effectiveness of ticagrelor versus clopidogrel among patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). A comprehensive literature search was done through various databases like PubMed, Google Scholar, EMBASE, Web of Science, and the Cochrane Database Library from January 15, 2023, to February 23, 2023. After careful screening, eight articles with highly significant variables were involved in the synthesis of this meta-analysis. Data analysis was done through Review Manager (RevMan, Version 5.4; The Cochrane Collaboration, Copenhagen, Denmark). In our study, ticagrelor and clopidogrel were evaluated in 10614 and 14662 patients, respectively. Ticagrelor was significantly superior to Clopidogrel in terms of all-cause mortality (RR 0.79, 95% CI 0.69-0.91, p = 0.001), risk of MI (RR 0.74, 95% CI 0.61-0.89, p = 0.001), and stroke (RR 0.64, 95% CI 0.42-0.98, p = 0.04), but a higher risk of bleeding events was observed with Ticagrelor (RR 1.36, 95% CI 1.04-1.79, p = 0.03). The two regimens were comparable in terms of stent thrombosis. Ticagrelor was found to be best in terms of reducing post-PCI myocardial infarction, stroke, stent thrombosis, and all other mortality events in comparison to Clopidogrel. However, the bleeding events were of significant concern for the utilization of ticagrelor and required further investigations.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.46455