Centre Hospitalier Régional et Universitaire de Lille, Lille, France.
Inserm U744, Institut Pasteur de Lille, Lille, France.
J Thromb Haemost. 2015 Jun;13(6):931-42. doi: 10.1111/jth.12907. Epub 2015 Apr 21.
Ticagrelor and prasugrel have shown superiority over clopidogrel. However, it remains unclear if one is superior to another regarding on-treatment platelet reactivity.
To compare the impact of ticagrelor and prasugrel on high on-treatment platelet reactivity (HTPR).
The 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.
We 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]).
Our 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.
替格瑞洛和普拉格雷均优于氯吡格雷。然而，在治疗中的血小板反应性方面，哪种药物更具优势仍不明确。
比较替格瑞洛和普拉格雷对高反应性血小板治疗（HTPR）的影响。
检索 2014 年 12 月 PubMed 和 Cochrane 数据库中关于替格瑞洛和普拉格雷比较的相关研究。符合纳入标准的研究为对比替格瑞洛和普拉格雷治疗 HTPR 的研究。采用随机效应模型计算合并估计值，置信区间为 95%。
共纳入 14 项研究，共 1822 例患者：替格瑞洛组 805 例，普拉格雷组 1017 例。替格瑞洛组 HTPR 发生率显著降低：1.5%比 9.8%（RR=0.27[0.14-0.50]）。关注随机试验的预设分析（n=10）显示了一致的结果（RR=0.27[0.12-0.60]）。
我们的研究结果表明，与普拉格雷相比，替格瑞洛可更好地抑制血小板反应性，进而进一步降低 HTPR 发生率。
