In:
Circulation: Cardiovascular Quality and Outcomes, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. Suppl_1 ( 2020-05)
Abstract:
Introduction: Dual antiplatelet therapy (DAPT) with a P2Y12 inhibitor added to aspirin is considered the standard of care for patients with acute coronary syndrome (ACS) undergoing percutaneous intervention (PCI). Prasugrel and ticagrelor are commonly used P2Y12 inhibitors. However, few head-to-head randomized controlled trials have been performed to directly compare the efficacy and safety of these two agents when used in patients with ACS undergoing PCI. Methods: We searched PubMed/MEDLINE and Cochrane library. The primary endpoint was major adverse cardiovascular events (MACE). Secondary outcomes were all-cause mortality, cardiovascular mortality, myocardial infarction (MI), stent thrombosis, major bleeding, and all bleeding event. Estimates were calculated as random effects risk ratios (RRs) with 95% confidence intervals (CI). Results: Six trials with 6807 patients were included [ FIGURE ]. There were no significant differences in MACE (RR 0.93; 95% CI [0.72-1.20] ; p = 0.59; I 2 = 26%), all-cause mortality (RR 0.92; 95% CI [0.73-1.17]; p = 0.51; I 2 = 0%),cardiovascular mortality (RR 0.99; 95% CI [0.75-1.31]; p = 0.96; I 2 = 0%), MI (RR 0.87; 95% CI [0.60-1.27]; p = 0.48; I 2 = 27%), stent thrombosis (RR 0.64; 95% CI [0.39-1.04]; p = 0.07; I 2 = 0%), major bleeding (RR 0.94; 95% CI [0.70-1.26]; p = 0.68; I 2 = 6%), and all bleeding events (RR 0.92; 95% CI [0.77-1.09]; p = 0.32; I 2 = 0%) when ticagrelor was compared to prasugrel. Conclusion: There are no significant difference of MACE, all-cause mortality, cardiovascular mortality, MI, stent thrombosis, and bleeding between prasugrel and ticagrelor for DAPT in PCI for ACS based current clinical trial data. However, the most recently published and largest of these trials suggests a reduction in MACE. More such comparisons are warranted to inform clinical practice.
Type of Medium:
Online Resource
ISSN:
1941-7713
,
1941-7705
DOI:
10.1161/hcq.13.suppl_1.325
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2453882-6
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