Safety of ticagrelor and clopidogrel for acute coronary syndromes: A systemic analysis / 解放军医学杂志

ABSTRACT

Objective To systemically evaluate the different on the incidence of cardiovascular events of platelet aggregation inhibitors ticagrelor and clopidogrel for acute coronary syndrome (ACS),so provide cardiovascular event reference for the selection ofACS platelet inhibitors.Methods Articles were collected according to the inclusion criteria from the database CNKI,Chongqing VIP,Taylor & Francis Open Access Journals,Wanfang,Cochrane Library,SinoMed,EMbase and PubMed from Jan.2000 to May 2017.Review Manager 5.3 was used for data analysis to get the odds ratio (OR) as final effect value.Publication bias of the literatures and the sensitivity of the study were also analyzed with the software.Results A total of 12 articles involving 86 849 patients were included,i.e.,8 random controlled trials,2 case control studies and 2 cohort studies.Quality assessment with Cochrane handbook for systematic reviews shows that,most studies gave low risks in 7 bias aspects.Jadad score assessment was employed in 8 random controlled trials,with 4 studies getting 3 points,3 getting 4 points and 1 getting 5 points,implying the significant quality of the included studies.Meta-analysis showed that compared with clopidogrel,significantly lower cardiovascular mortality (OR=0.80,95％CI0.72-0.89,P＜0.01) and incidence of myocardial infarction (OR=0.78,95％CI0.61-0.99,P＜0.05)were with ticagrelor.Conclusion Compared to clopidogrel,ticagrelor may lead to lower cardiovascular mortality and incidence of myocardial infarction in treatment of ACS.