Journal
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
Volume 13, Issue 6, Pages 931-942Publisher
WILEY
DOI: 10.1111/jth.12907
Keywords
acute coronary syndrome; antiplatelet agents; coronary artery disease; percutaneous coronary intervention; platelet function tests
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Funding
- Astra Zeneca
- Daiichi Sankyo
- Lilly
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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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