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...

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Autores principales: 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
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Publicado: John Wiley and Sons Inc 2025
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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.
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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
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