Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndrome and on Dialysis: A Meta-Analysis.

Autor:	Chenna VSH; Medicine, University of Perpetual Help System Dalta, Las Pinas, PHL., Anam H; Medicine, Apollo institute of Medical Sciences and Research, Hyderabad, IND., Hassan M; Medicine, Universidad Autonoma de Guadalajara, Sacramento, USA., Moeez A; Medicine, Services Hospital Lahore, Lahore, PAK., Reddy R; Medicine, MNR Medical College and Hospital, Hyderabad, IND., Chaudhari SS; General Practice, Lions General Hospital, Mehsana, IND.; General Practice, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Vadnagar, IND., Sapkota K; Medicine, All India Institute of Medical Sciences (AIIMS) Bathinda, Bathinda, IND., Usama M; Neurology, Sheikh Zayed Medical College/Hospital Rahim Yar Khan, Rahim Yar Khan, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Jun 10; Vol. 15 (6), pp. e40211. Date of Electronic Publication: 2023 Jun 10 (Print Publication: 2023).
DOI:	10.7759/cureus.40211
Abstrakt:	This study aims to compare the safety and efficacy of clopidogrel and ticagrelor in patients with acute coronary syndrome (ACS) and undergoing dialysis. This study was conducted per the guidelines of the Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was performed using electronic databases, including PubMed, EMBASE, and Web of Science, to identify relevant studies comparing clopidogrel and ticagrelor in patients undergoing dialysis. To ensure the inclusion of all relevant articles, a combination of the following keywords, along with medical subject heading (MeSH) terms, was used: "clopidogrel," "ticagrelor," "acute coronary syndrome," and "dialysis." The primary endpoint of this meta-analysis was the incidence of major adverse cardiovascular events (MACE), which consisted of cardiovascular death, myocardial infarction, stroke, and revascularization. The secondary endpoint was all-cause mortality. The occurrence of any bleeding events (including major and nonmajor bleeding events) and major bleeding events was chosen as the safety endpoints. A total of four studies were included in the pooled analysis. The pooled sample size was 5,417 patients, including 892 in the ticagrelor group and 4525 in the clopidogrel group. The findings indicate that ticagrelor, compared to clopidogrel, is associated with a significantly higher risk of MACEs, all-cause death, and major bleeding events. The findings suggest that clopidogrel may be a better choice for individuals with ACS undergoing dialysis due to its lower risk of MACE, all-cause death, and major bleeding events compared to ticagrelor. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Chenna et al.)
Databáze:	MEDLINE
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