Ticagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis
Background Current guidelines recommend clopidogrel in patients with chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI), yet the comparative benefits are unclear. Aims The aim of this study was to evaluate the efficacy and safety of ticagrelor versus clopidogrel in p...
Guardado en:
| Autores principales: | , , , , , , , , |
|---|---|
| Formato: | Artículo |
| Lenguaje: | inglés |
| Publicado: |
John Wiley and Sons Inc
2025
|
| Materias: | |
| Acceso en línea: | Enlace permanente (DOI o Handle) |
| Etiquetas: |
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| _version_ | 1881508879949365248 |
|---|---|
| author | Pinedo-Avila, Johann Bill Valera-Cabrera, Jessica Lucia Avalos-Rodríguez, Ana Fernández-Poma, Sarita Milagros Castro, Carlos Enrique Martínez Cañote, Renzo G. Chocce, Karina Taype-Rondán, Álvaro Renzo Soriano Moreno, David |
| author_browse | Avalos-Rodríguez, Ana Castro, Carlos Enrique Martínez Cañote, Renzo G. Chocce, Karina Fernández-Poma, Sarita Milagros Pinedo-Avila, Johann Bill Soriano Moreno, David Taype-Rondán, Álvaro Renzo Valera-Cabrera, Jessica Lucia |
| author_facet | Pinedo-Avila, Johann Bill Valera-Cabrera, Jessica Lucia Avalos-Rodríguez, Ana Fernández-Poma, Sarita Milagros Castro, Carlos Enrique Martínez Cañote, Renzo G. Chocce, Karina Taype-Rondán, Álvaro Renzo Soriano Moreno, David |
| author_sort | Pinedo-Avila, Johann Bill |
| collection | Producción científica |
| description | Background Current guidelines recommend clopidogrel in patients with chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI), yet the comparative benefits are unclear. Aims The aim of this study was to evaluate the efficacy and safety of ticagrelor versus clopidogrel in patients with CCS undergoing PCI. Methods We searched PubMed/MEDLINE, EMBASE, CENTRAL databases from inception to February 15, 2025. We included parallel randomized controlled trials (RCTs) involving adults with CCS undergoing PCI, where the intervention group received ticagrelor as maintenance therapy and the control group received clopidogrel. Primary outcomes included all‐cause or cardiovascular mortality, myocardial infarction, quality of life, heart failure, stroke/transient ischemic attack (TIA), revascularization, and adverse events. Study selection and data extraction were conducted independently. We determined the certainty of evidence using the GRADE approach. Results We included nine RCTs, with 3370 patients. Compared to clopidogrel, ticagrelor probably results in no important difference in cardiovascular mortality and hospital stay; may not have an important effect on stroke and/or TIA; and may not have an important effect on all‐cause mortality, heart failure, and revascularization, but the evidence is very uncertain. Additionally, the evidence is very uncertain about the effect on myocardial infarction. Regarding safety outcomes, ticagrelor probably results in no important difference in major bleeding, minor bleeding, any bleeding, or dyspnea. However, it probably increases the risk of chest pain/tightness ( + 7.5 per 100; 95% CI: +1.4 to +21.7). Conclusion In patients with CCS undergoing PCI, ticagrelor probably has a similar efficacy and safety to clopidogrel in most cardiovascular outcomes. However, it probably increases the risk of chest pain/tightness. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/2845 |
| institution | UPeU |
| language | English |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | John Wiley and Sons Inc |
| publisherStr | John Wiley and Sons Inc |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/28452026-10-30T17:10:21ZTicagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-AnalysisPinedo-Avila, Johann BillValera-Cabrera, Jessica LuciaAvalos-Rodríguez, AnaFernández-Poma, Sarita MilagrosCastro, Carlos Enrique MartínezCañote, Renzo G.Chocce, KarinaTaype-Rondán, Álvaro RenzoSoriano Moreno, DavidAngioplasty, Balloon, CoronaryChronic Coronary SyndromePlatelet aggregation inhibitorscoronary artery diseaseClopidogrelTicagrelorAngioplastyBalloonCoronaryBackground Current guidelines recommend clopidogrel in patients with chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI), yet the comparative benefits are unclear. Aims The aim of this study was to evaluate the efficacy and safety of ticagrelor versus clopidogrel in patients with CCS undergoing PCI. Methods We searched PubMed/MEDLINE, EMBASE, CENTRAL databases from inception to February 15, 2025. We included parallel randomized controlled trials (RCTs) involving adults with CCS undergoing PCI, where the intervention group received ticagrelor as maintenance therapy and the control group received clopidogrel. Primary outcomes included all‐cause or cardiovascular mortality, myocardial infarction, quality of life, heart failure, stroke/transient ischemic attack (TIA), revascularization, and adverse events. Study selection and data extraction were conducted independently. We determined the certainty of evidence using the GRADE approach. Results We included nine RCTs, with 3370 patients. Compared to clopidogrel, ticagrelor probably results in no important difference in cardiovascular mortality and hospital stay; may not have an important effect on stroke and/or TIA; and may not have an important effect on all‐cause mortality, heart failure, and revascularization, but the evidence is very uncertain. Additionally, the evidence is very uncertain about the effect on myocardial infarction. Regarding safety outcomes, ticagrelor probably results in no important difference in major bleeding, minor bleeding, any bleeding, or dyspnea. However, it probably increases the risk of chest pain/tightness ( + 7.5 per 100; 95% CI: +1.4 to +21.7). Conclusion In patients with CCS undergoing PCI, ticagrelor probably has a similar efficacy and safety to clopidogrel in most cardiovascular outcomes. However, it probably increases the risk of chest pain/tightness.Article10.1002/ccd.701552-s2.0-105015562820https://hdl.handle.net/20.500.15037/2845enCatheterization and Cardiovascular InterventionsCatheterization and Cardiovascular Interventions1522-1946John Wiley and Sons Inc2025-09-092026-06-27T02:34:15Z2026-06-27T02:34:15Z |
| spellingShingle | Angioplasty, Balloon, Coronary Chronic Coronary Syndrome Platelet aggregation inhibitors coronary artery disease Clopidogrel Ticagrelor Angioplasty Balloon Coronary Pinedo-Avila, Johann Bill Valera-Cabrera, Jessica Lucia Avalos-Rodríguez, Ana Fernández-Poma, Sarita Milagros Castro, Carlos Enrique Martínez Cañote, Renzo G. Chocce, Karina Taype-Rondán, Álvaro Renzo Soriano Moreno, David Ticagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis |
| title | Ticagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis |
| title_full | Ticagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis |
| title_fullStr | Ticagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Ticagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis |
| title_short | Ticagrelor Versus Clopidogrel in Patients With Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis |
| title_sort | ticagrelor versus clopidogrel in patients with chronic coronary syndrome undergoing percutaneous coronary intervention a systematic review and meta analysis |
| topic | Angioplasty, Balloon, Coronary Chronic Coronary Syndrome Platelet aggregation inhibitors coronary artery disease Clopidogrel Ticagrelor Angioplasty Balloon Coronary |
| topic_facet | Angioplasty, Balloon, Coronary Chronic Coronary Syndrome Platelet aggregation inhibitors coronary artery disease Clopidogrel Ticagrelor Angioplasty Balloon Coronary |
| url | https://hdl.handle.net/20.500.15037/2845 |
| work_keys_str_mv | AT pinedoavilajohannbill ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis AT valeracabrerajessicalucia ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis AT avalosrodriguezana ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis AT fernandezpomasaritamilagros ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis AT castrocarlosenriquemartinez ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis AT canoterenzog ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis AT choccekarina ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis AT tayperondanalvarorenzo ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis AT sorianomorenodavid ticagrelorversusclopidogrelinpatientswithchroniccoronarysyndromeundergoingpercutaneouscoronaryinterventionasystematicreviewandmetaanalysis |