Prasugrel Versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: a Systematic Review and Meta-analysis of Randomized Trials.
Acute Coronary Syndrome
/ surgery
Aspirin
/ therapeutic use
Dual Anti-Platelet Therapy
/ adverse effects
Hemorrhage
/ chemically induced
Humans
Percutaneous Coronary Intervention
/ methods
Platelet Aggregation Inhibitors
/ administration & dosage
Prasugrel Hydrochloride
/ administration & dosage
Randomized Controlled Trials as Topic
Ticagrelor
/ administration & dosage
Acute coronary syndrome
Meta-analysis
Percutaneous coronary intervention
Prasugrel
Ticagrelor
Journal
Cardiovascular drugs and therapy
ISSN: 1573-7241
Titre abrégé: Cardiovasc Drugs Ther
Pays: United States
ID NLM: 8712220
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
accepted:
13
08
2020
pubmed:
21
8
2020
medline:
16
12
2021
entrez:
21
8
2020
Statut:
ppublish
Résumé
Dual antiplatelet therapy (DAPT) with aspirin and ticagrelor or prasugrel is the mainstay of treatment for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). We aimed to systematically perform a head-to-head comparison of ticagrelor vs prasugrel in terms of efficacy and safety. We searched PubMed/Medline, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant published randomized controlled trials (RCTs). The primary outcome was adverse cardiovascular events and secondary outcome was bleeding events. A random-effects meta-analysis was used to obtain the pooled estimate of each outcome. Nine RCTs with a total number of 6990 patients (3550 treated with prasugrel and 3481 treated with ticagrelor) were included. No significant difference between prasugrel and ticagrelor was observed in terms of mortality (OR 0.86, 95% CI 0.66 to 1.13, P = 0.28), major adverse cardiovascular events (MACEs) (OR 0.85, 95% CI 0.70 to 1.03, P = 0.10), non-fatal myocardial infarction (OR 0.78, 95% CI 0.57 to 1.06, P = 0.11), stroke (OR 1.02, 95% CI 0.60 to 1.72, P = 0.95), stent thrombosis (OR 0.76, 95% CI 0.47 to 1.21, P = 0.25), thrombolysis in myocardial infarction (TIMI) defined major (OR 0.94, 95% CI 0.19 to 4.67, P = 0.94), minor (OR 0.35, 95% CI 0.08 to 1.62, P = 0.18) and minimal (OR 0.48, 95% CI 0.19 to 1.18, P = 0.11) bleeding and Bleeding Academic Research Consortium (BARC) defined bleeding (OR 1.06, 95% CI 0.82 to 1.36, P = 0.68). In patients with ACS undergoing PCI, both prasugrel and ticagrelor were associated with similar cardiovascular outcomes and adverse bleeding events.
Identifiants
pubmed: 32816142
doi: 10.1007/s10557-020-07056-z
pii: 10.1007/s10557-020-07056-z
doi:
Substances chimiques
Platelet Aggregation Inhibitors
0
Prasugrel Hydrochloride
G89JQ59I13
Ticagrelor
GLH0314RVC
Aspirin
R16CO5Y76E
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
561-574Références
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