Ticagrelor versus clopidogrel in East-Asian patients with acute coronary syndromes: a meta-analysis of randomized trials
Abstract
Aim: To determine whether ticagrelor or clopidogrel provides the best outcomes for East-Asian patients with acute coronary syndrome (ACS). Materials & methods: Identification and interrogation of electronic databases through 26 July 2016 revealed fully randomized and controlled trials wherein primary efficacy end points were major adverse cardiovascular events and all-cause death among East-Asian patients with ACS. Major bleeding and noncoronary artery bypass grafts major bleeding were primary safety end points. Results: Two studies met the inclusion criteria. Compared with clopidogrel, ticagrelor has no statistical difference in the end points of major adverse cardiovascular events (risk ratio [RR]: 1.08; 95% CI: 0.62–1.91; p = 0.7260), myocardial infarction (RR: 1.200; 95% CI: 0.64–2.24; p = 0.5669), stroke (RR: 1.11; 95% CI: 0.46–2.66; p = 0.8165), cardiovascular death (RR: 0.89; 95% CI: 0.48–1.65; p = 0.7150), or all-cause mortality (RR: 0.92; 95% CI: 0.43–1.96; p = 0.8252). When compared with clopidogrel, it was found that ticagrelor provoked marked increases in major bleeding (RR: 1.48; p = 0.0430) and noncoronary artery bypass grafts-associated major bleeding (RR: 1.62; p = 0.0454). Conclusion: Ticagrelor and clopidogrel displayed similar efficacies in ACS presenting patients from East Asia. Administration of ticagrelor also displays some side effects including an increased risk of major bleeding.
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© 2017 Future Medicine Ltd.
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Received: 21 September 2017
Accepted: 16 October 2017
Published online: 2 November 2017
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Ticagrelor versus clopidogrel in East-Asian patients with acute coronary syndromes: a meta-analysis of randomized trials. (2017) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2017-0074
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