Ticagrelor for Asian patients with acute coronary syndrome in real-world practice: A systematic review and meta-analysis of observational studies.

Authors:
Akhmetzhan Maratovich Galimzhanov
Akhmetzhan Maratovich Galimzhanov
State Medical University of Semey

Indian Heart J 2019 Jan - Feb;71(1):15-24. Epub 2019 Jan 25.

University Hospital of State Medical University of Semey, Department of Endovascular Surgery, Semey, Kazakhstan.

Objective: We aimed to assess the efficacy and safety of ticagrelor compared to clopidogrel in Asian patients with acute coronary syndrome (ACS) in real-world practice.

Methods: PubMed, Web of Science and Scopus databases were searched systematically to obtain relevant Asian observational studies.

Results: The meta-analysis included six studies with 27959 participants. Compared with clopidogrel, ticagrelor was significantly beneficial in prevention of major adverse cardiac events (MACCEs) (OR=0.62; 95% CI: 0.46-0.83, I=69%, p=0.001) mainly driven by reducing stroke (OR=0.62; 95% CI: 0.49-0.78, I=0%, p<0.001). No differences were found between ticagrelor and clopidogrel in the risk of cardiovascular mortality (OR=0.66; 95% CI: 0.41-1.06, I=0%, p=0.09), target vessel revascularization (OR=0.53; 95% CI: 0.21-1.35, I=82%, p=0.18), major bleeding (OR=1.11; 95% CI: 0.62-2.00, I=75%, p=0.73), and net adverse clinical and cerebral events (OR=0.76; 95% CI: 0.55-1.04, I=78%, p=0.09). However, ticagrelor significantly increased the incidence of major/minor (OR=1.73; 95% CI: 1.36-2.21, I=0%, p<0.001) and minor bleeding (OR=1.73; 95% CI: 1.29-2.32, I=0%, p<0.001). Sensitivity analyses did not find consistent effect of ticagrelor on prevention of all-cause death and myocardial infarction.

Conclusion: This meta-analysis suggested that ticagrelor might reduce the risk of MACCEs mainly by reducing stroke in Asian patients with ACS without increasing the rates of major bleeding. Ticagrelor did not show a significant effect on other parts of MACCEs. Considerable increase in the risk of major/minor and minor bleeding was observed in ticagrelor compared with clopidogrel users. Further high-quality studies are required to support these findings.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ihj.2019.01.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477146PMC
January 2019
3 Reads

Article Mentions


Provided by Crossref Event Data
twitter
Twitter:
March 15, 2019, 11:30 pm EST
twitter
Twitter:
March 14, 2019, 11:01 am EST
twitter
Twitter:
March 14, 2019, 10:50 am EST
twitter
Twitter:
March 14, 2019, 1:39 am EST
twitter
Twitter:
March 14, 2019, 1:32 am EST
twitter
Twitter:
January 27, 2019, 4:37 am EST

Publication Analysis

Top Keywords

or=062 95%
8
acute coronary
8
coronary syndrome
8
patients acute
8
compared clopidogrel
8
asian patients
8
observational studiesresults
4
asian observational
4
relevant asian
4
studiesresults meta-analysis
4
27959 participants
4
studies 27959
4
meta-analysis included
4
included studies
4
databases searched
4
pubmed web
4
practicemethods pubmed
4
real-world practicemethods
4
web science
4
science scopus
4

Similar Publications