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Article: Efficacy and safety of newer P2Y12 inhibitors for acute coronary syndrome: a network meta-analysis
Title | Efficacy and safety of newer P2Y12 inhibitors for acute coronary syndrome: a network meta-analysis |
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Authors | |
Keywords | acute coronary syndrome human meta analysis network meta-analysis treatment outcome |
Issue Date | 2020 |
Publisher | Nature Research (part of Springer Nature): Fully open access journals. The Journal's web site is located at http://www.nature.com/srep/index.html |
Citation | Scientific Reports, 2020, v. 10, p. article no. 16794 How to Cite? |
Abstract | Whether newer P2Y12 inhibitors are more efficacious and safer than clopidogrel and whether there is a superior one remain uncertain. We compared the effect of P2Y12 inhibitors on clinical outcomes in patients with acute coronary syndrome (ACS). Randomized controlled trials comparing clopidogrel, prasugrel, ticagrelor, or cangrelor, in combination with aspirin were searched. Sixteen trials with altogether 77,896 patients were included. Compared to clopidogrel, cardiovascular mortality was reduced with prasugrel (OR 0.85, 95% CI 0.75–0.97) and ticagrelor (0.82, 0.73–0.93). Myocardial infarction (0.75, 0.63–0.89) and major adverse cardiovascular events (0.80, 0.69–0.94) were reduced by prasugrel. Stent thrombosis was reduced by prasugrel (0.49, 0.38–0.63), ticagrelor (0.72, 0.57–0.90), and cangrelor (0.59, 0.43–0.81). It was reduced more by prasugrel than ticagrelor (0.69, 0.51–0.93). There were more major bleeds with prasugrel (1.24, 1.05–1.48). Thrombolysis in Myocardial Infarction (TIMI) major bleeding was increased with prasugrel compared to clopidogrel (1.36, 1.11–1.66) and ticagrelor (1.33, 1.06–1.67). TIMI minor bleeding was increased with prasugrel (1.44, 1.16–1.77) and cangrelor (1.47, 1.01–2.16) compared to clopidogrel while it was increased with prasugrel compared to ticagrelor (1.32, 1.01–1.72). Prasugrel is preferable to those ACS patients at low bleeding risk to reduce cardiovascular events whereas ticagrelor is a relatively safe antiplatelet drug of choice for most patients. |
Persistent Identifier | http://hdl.handle.net/10722/290927 |
ISSN | 2023 Impact Factor: 3.8 2023 SCImago Journal Rankings: 0.900 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Fei, Y | - |
dc.contributor.author | Lam, CK | - |
dc.contributor.author | Cheung, BMY | - |
dc.date.accessioned | 2020-11-02T05:49:04Z | - |
dc.date.available | 2020-11-02T05:49:04Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Scientific Reports, 2020, v. 10, p. article no. 16794 | - |
dc.identifier.issn | 2045-2322 | - |
dc.identifier.uri | http://hdl.handle.net/10722/290927 | - |
dc.description.abstract | Whether newer P2Y12 inhibitors are more efficacious and safer than clopidogrel and whether there is a superior one remain uncertain. We compared the effect of P2Y12 inhibitors on clinical outcomes in patients with acute coronary syndrome (ACS). Randomized controlled trials comparing clopidogrel, prasugrel, ticagrelor, or cangrelor, in combination with aspirin were searched. Sixteen trials with altogether 77,896 patients were included. Compared to clopidogrel, cardiovascular mortality was reduced with prasugrel (OR 0.85, 95% CI 0.75–0.97) and ticagrelor (0.82, 0.73–0.93). Myocardial infarction (0.75, 0.63–0.89) and major adverse cardiovascular events (0.80, 0.69–0.94) were reduced by prasugrel. Stent thrombosis was reduced by prasugrel (0.49, 0.38–0.63), ticagrelor (0.72, 0.57–0.90), and cangrelor (0.59, 0.43–0.81). It was reduced more by prasugrel than ticagrelor (0.69, 0.51–0.93). There were more major bleeds with prasugrel (1.24, 1.05–1.48). Thrombolysis in Myocardial Infarction (TIMI) major bleeding was increased with prasugrel compared to clopidogrel (1.36, 1.11–1.66) and ticagrelor (1.33, 1.06–1.67). TIMI minor bleeding was increased with prasugrel (1.44, 1.16–1.77) and cangrelor (1.47, 1.01–2.16) compared to clopidogrel while it was increased with prasugrel compared to ticagrelor (1.32, 1.01–1.72). Prasugrel is preferable to those ACS patients at low bleeding risk to reduce cardiovascular events whereas ticagrelor is a relatively safe antiplatelet drug of choice for most patients. | - |
dc.language | eng | - |
dc.publisher | Nature Research (part of Springer Nature): Fully open access journals. The Journal's web site is located at http://www.nature.com/srep/index.html | - |
dc.relation.ispartof | Scientific Reports | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | acute coronary syndrome | - |
dc.subject | human | - |
dc.subject | meta analysis | - |
dc.subject | network meta-analysis | - |
dc.subject | treatment outcome | - |
dc.title | Efficacy and safety of newer P2Y12 inhibitors for acute coronary syndrome: a network meta-analysis | - |
dc.type | Article | - |
dc.identifier.email | Fei, Y: fayeyfei@hku.hk | - |
dc.identifier.email | Cheung, BMY: mycheung@hkucc.hku.hk | - |
dc.identifier.authority | Cheung, BMY=rp01321 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1038/s41598-020-73871-x | - |
dc.identifier.pmid | 33033323 | - |
dc.identifier.pmcid | PMC7545197 | - |
dc.identifier.scopus | eid_2-s2.0-85092307804 | - |
dc.identifier.hkuros | 317702 | - |
dc.identifier.volume | 10 | - |
dc.identifier.spage | article no. 16794 | - |
dc.identifier.epage | article no. 16794 | - |
dc.identifier.isi | WOS:000577475100018 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 2045-2322 | - |