High on-treatment platelet reactivity with ticagrelor versus prasugrel: a systematic review and meta-analysis

被引：50
作者：
Lemesle, G. [1 ,2 ,3 ]
Schurtz, G. [1 ]
Bauters, C. [1 ,2 ,3 ]
Hamon, M. [4 ,5 ]
机构：
[1] CHRU Lille, F-59037 Lille, France
[2] Inst Pasteur, Inserm U744, F-59019 Lille, France
[3] Univ Lille, Fac Med, Lille, France
[4] Ctr Hosp Univ Caen, Caen, France
[5] Fac Med Caen, Caen, France
来源：
JOURNAL OF THROMBOSIS AND HAEMOSTASIS | 2015年 / 13卷 / 06期
关键词：
acute coronary syndrome; antiplatelet agents; coronary artery disease; percutaneous coronary intervention; platelet function tests; ACUTE CORONARY SYNDROME; ASPIRIN-TREATED PATIENTS; MYOCARDIAL-INFARCTION; RANDOMIZED ASSESSMENT; DOSE CLOPIDOGREL; ACHIEVES GREATER; INHIBITION; INTERVENTION; EVENTS; IMPACT;
D O I：
10.1111/jth.12907
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
BackgroundTicagrelor and prasugrel have shown superiority over clopidogrel. However, it remains unclear if one is superior to another regarding on-treatment platelet reactivity. ObjectivesTo compare the impact of ticagrelor and prasugrel on high on-treatment platelet reactivity (HTPR). MethodsThe PubMed and Cochrane databases were searched for eligible studies in December 2014. Studies were eligible if they compared ticagrelor and prasugrel regarding high on-treatment platelet reactivity (HTPR). Pooled estimates were calculated by using a random-effects model with 95% confidence intervals. ResultsWe included 14 studies and 1822 patients: 805 and 1017 in the ticagrelor and prasugrel groups, respectively. The rate of HTPR was significantly lower in the ticagrelor group: 1.5% vs. 9.8% (RR=0.27 [0.14-0.50]). The pre-specified analysis focusing on randomized trials (n=10) showed consistent results (RR=0.27 [0.12-0.60]). ConclusionOur results suggest that ticagrelor allows a higher platelet reactivity inhibition as compared with prasugrel and leads to a further decrease in the rate of HTPR.
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收藏
页码：931 / 942
页数：12
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