Effectiveness and securities of ticagrelor and clopidogrel in antiplatelet therapy for coronary heart disease in old people:A Meta-analysis / 吉林大学学报(医学版)

ABSTRACT

Objective:To explore the curative effects and securities of ticagrelor and clopidogrel in the antiplatelet therapy for coronary heart disease in the aged patients, and to provide a more rational strategy for antiplatelet therapy.Methods:Computer search was performed in Cochrane Central Register of Controlled Trial, Ovid-Medline, EMBase, PubMed, CNKI, Wanfang, VIP and CBM, and the randomized controlled trial (RCT) of ticagrelor and clopidogrel in the treatment of coronary heart disease in the old people were collected.The patients in ticagrelor group were given ticagrelor and other drugs, and the patients in clopidogrel group were given clopidogrel and other drugs.RevMan 5.3software was used to perform Meta-analysis, and the adverse events related to the effectiveness such as the major adverse cardiovascular events (MACE) , myocardial infarction (MI) , stent thrombosis, death, stroke and the adverse events related to safety (bleeding event) were observed.Results:According to inclusion and exclusion criteria, a total of 15RCT were included.The results of Meta-analysis showed that the incidences of MACE (RR=0.59, 95％CI0.46-0.76, Z=4.08, P＜0.01) , MI (RR=0.48, 95％CI0.28-0.81, Z=2.74, P=0.006) , stent thrombosis (RR=0.16, 95％CI0.06-0.48, Z=3.30, P=0.0010) , and death (RR=0.52, 95％CI0.30-0.89, Z=2.41, P=0.02) in ticagrelor group were decreased compared with clopidogrel group;there was no significant difference in stroke rate (RR=0.76, 95％CI0.39-1.47, Z=0.81, P=0.42) between two groups, and the incidence of bleeding event in ticagrelor group was increased compared with clopidogrel group (RR=1.57, 95％CI1.20-2.05, Z=3.28, P=0.001) .Conclusion:For the aged patients with coronary heart disease, ticagrelor is superior to clopidogrel;but the incidence of bleeding is increased.