替格瑞洛和氯吡格雷在经皮冠状动脉介入治疗患者中的疗效比较:一项荟萃分析。

Jian Yang, Ping Zeng, Wan-Yin Cai
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引用次数: 2

摘要

我们进行了一项随机对照试验(rct)的荟萃分析,以研究替格瑞洛(TIC)与氯吡格雷(CLO)在经皮冠状动脉介入治疗(PCI)患者中的疗效和安全性。2016年6月开始进行文献检索,所有研究时间为2010 - 2015年。我们通过MEDLINE数据库、Cochrane图书馆和EMBASE数据库系统地检索文献。质量评价采用Jadad质量量表进行评价。数据的提取考虑了疗效和安全性设计的特点。6项rct共纳入26244名受试者,符合纳入标准。全因死亡率(MD=0.83, 95%CI=0.74 ~ 0.93, P=0.001)和心肌梗死(MI) (MD=0.78, 95%CI=0.70 ~ 0.88, P=0.000)显著降低。在卒中(MD=1.34, 95%CI=0.99-1.79, P=0.06)、总出血(MD=0.97, 95%CI=0.84-1.12, P=0.66)、轻度或重度出血(MD=1.06, 95%CI=0.94-1.19, P=0.35)两组患者在TIC与CLO治疗后行PCI的差异均无统计学意义。在降低全因死亡率和心肌梗死方面,TIC比CLO更显著,但在抑制PCI患者卒中、大出血、大出血和小出血方面,TIC与CLO无显著差异。
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Comparison of treatment outcomes of ticagrelor and clopidogrel among patients undergoing percutaneous coronary intervention: A meta-analysis.

We performed a meta-analysis of randomized controlled trials (RCTs) to investigate the efficacy and safety of ticagrelor (TIC) vs. clopidogrel (CLO) in patients undergoing percutaneous coronary intervention (PCI). In Jun 2016, a literature search was started and all the studies were conducted from 2010 to 2015. We systematically searched the literature through the MEDLINE database, Cochrane library, and EMBASE database. Quality assessments were evaluated with Jadad quality scale. Data were extracted considering the characteristics of efficacy and safety designs. Six RCTs enrolling 26 244 participants and satisfying the inclusion criteria were finally analyzed. There was a significant decrease of all-cause mortality (MD=0.83, 95%CI=0.74-0.93, P=0.001) and myocardial infarction (MI) (MD=0.78, 95%CI=0.70-0.88, P=0.000). There were no significant differences in stroke (MD=1.34, 95%CI=0.99-1.79, P=0.06), total bleeding (MD=0.97, 95%CI=0.84-1.12, P=0.66), minor or major bleeding (MD=1.06, 95%CI=0.94-1.19, P=0.35) in patients undergoing PCI after treatment with TIC vs. CLO. TIC could be more significant in decreasing all-cause mortality and MI than CLO, but there were no significant differences between TIC and CLO in inhibiting stroke, major bleeding, major or minor bleeding in patients undergoing PCI.

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